TITLE

Acute Pancreatitis after Cardiac Transplantation and Other Cardiac Procedures: Case-Control Analysis in 24,631 Patients

AUTHOR(S)
Herline, A.J.; Pinson, C.W.
PUB. DATE
September 1999
SOURCE
American Surgeon;Sep1999, Vol. 65 Issue 9, p819
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Previous series have identified an increased risk of developing acute postoperative pancreatitis in heart transplant recipients and other cardiac surgical patients, and some suggest that mortality is significantly increased when pancreatitis occurs in the transplant setting. We conducted a retrospective case-control analysis of adult patients undergoing orthotopic heart transplant or other cardiac procedures from April 1985 through June 1996 at our medical center. Specific risk factors for outcome were assessed including low cardiac output, intra-aortic balloon pump usage, exogenous calcium repletion, immunosuppression, cytomegalovirus infection, cholelithiasis, prior pancreatitis, and Acute Physiology and Chronic Health Evaluation (APACHE) II scores. There was a 30-fold increase in the incidence of pancreatitis in the heart transplant group [12 of 394 (3%) vs 27 of 24,237 (0.1%); P < 0.01]. Compared with the nontransplant cardiopulmonary bypass patients, the transplant patients experienced a statistically significant increased incidence of immunosuppression and three or more risk factors. Transplant patients with pancreatitis demonstrated a significant increase in APACHE II scores and the incidence of three or more risk factors compared with their transplant control group. Patients undergoing nontransplant cardiac procedures and developing pancreatitis had significantly increased crossclamp times, incidence of low cardiac output, APACHE II scores, and incidence of three or more risk factors compared with their nontransplant cohort. In conclusion, there is a significant increase in the incidence of pancreatitis after orthotopic heart transplant compared with other cardiac procedures. Analysis demonstrates the additive effect of multiple individual risk factors. Immunosuppression confers significant additional risk for pancreatitis in the orthotopic heart transplant patient.
ACCESSION #
2258983

 

Related Articles

  • Perioperative care in an adolescent patient with heparin-induced thrombocytopenia for placement of a cardiac assist device and heart transplantation: case report and literature review. Mineto Kamata; Sebastian, Roby; McConnell, Patrick I.; Gomez, Daniel; Naguib, Aymen; Tobias, Joseph D. // International Medical Case Reports Journal;Feb2017, Vol. 10, p55 

    Heparin-induced thrombocytopenia (HIT) can cause life-threatening complications following the administration of heparin. Discontinuation of all sources of heparin exposure and the use of alternative agents for anticoagulation are necessary when HIT is suspected or diagnosed. We present the...

  • Anesthetic management of heterotopic heart transplantation on beating heart. Kılıckan, Levent; Baykara, Nur; Toker, Kamil; Tekinalp, Haldun; Akbasş, Haluk; Alp, Mete // Journal of Anesthesia;2000, Vol. 14 Issue 2, p109 

    Presents a method of anesthesia and a technique for heterotopic heart transplantation without cardiopulmonary bypass. Details of the case of a man who had end-stage dilated cardiomyopathy; Indications for heterotopic heart transplantation; Why heterotopic heart transplantation has been...

  • Percutaneous Extracorporeal Membrane Oxygenation for Graft Dysfunction after Heart Transplantation. Jae Hong Lim; Ho Young Hwang; Sang Yoon Yeom; Hyun-Jai Cho; Hae-Young Lee; Ki-Bong Kim // Korean Journal of Thoracic & Cardiovascular Surgery;Apr2014, Vol. 47 Issue 2, p100 

    Background: We evaluated the safety and efficacy of percutaneous extracorporeal membrane oxygenation (ECMO) in patients with primary graft dysfunction after heart transplantation. Methods: Of 65 patients (44 males and 21 females) who underwent heart transplantation from January 2006 to December...

  • Ultra fast-track extubation in heart transplant surgery patients. Kianfar, Amir Abbas; Ahmadi, Zargham Hossein; Mirhossein, Seyed Mohsen; Jamaati, Hamidreza; Kashani, Babak Sharif; Mohajerani, Seyed Amir; Firoozi, Ehsan; Salehi, Farshid; Radmand, Golnar; Hashemian, Seyed Mohammadreza // International Journal of Critical Illness & Injury Science;Apr-Jun2015, Vol. 5 Issue 2, p89 

    Background: Heart transplant surgeries using cardiopulmonary bypass (CPB) typically requires mechanical ventilation in intensive care units (ICU) in post-operation period. Ultra fast-track extubation (UFE) have been described in patients undergoing various cardiac surgeries. Aim: To determine...

  • CardioWest temporary total artificial heart. Platis, Anthony; Larson, Douglas F. // Perfusion;Sep2009, Vol. 24 Issue 5, p341 

    Background: The CardioWest temporary total artificial heart (TAH-t) replaces both native ventricles of the heart and is more beneficial for a select group of patients than most other typical ventricular assist devices (VADs). This review will expand on the current literature and highlight the...

  • Short-Term Effects and Safety Analysis of Retrograde Autologous Blood Priming for Cardiopulmonary Bypass in Patients with Cardiac Valve Replacement Surgery. Cheng, Ming; Li, Jun-Quan; Wu, Tian-Chi; Tian, Wei-Chen // Cell Biochemistry & Biophysics;Nov2015, Vol. 73 Issue 2, p441 

    This randomized, double-blind study evaluated the short-term effects and safety of perioperative retrograde autologous priming (RAP) for cardiopulmonary bypass (CPB) in patients with cardiac replacement surgery to determine if this approach is a better substitute for crystal liquids priming in...

  • Intraoperative Anticoagulation Management during Cardiac Transplantation. Wadia, Yasmin; Cooper Jr., John R.; Bracey, Arthur W.; Pinto, Katheleen; Frazier, O. H. // Texas Heart Institute Journal;2008, Vol. 35 Issue 1, p62 

    Heparin-induced thrombocytopenia is an immunologically mediated syndrome that is associated with potentially life-threatening arterial and venous thrombosis. Re-exposing patients who have heparin-induced thrombocytopenia to heparin during cardiopulmonary bypass may be hazardous. We describe the...

  • Patent Ductus Arteriosus with Eisenmenger Syndrome. Moustafa, Sherif; Patton, David J.; Balon, Yvonne; Connelly, Michael S.; Alvarez, Nanette // Heart, Lung & Circulation;Nov2013, Vol. 22 Issue 11, p968 

    Herein we report a 21 year-old woman with a previously documented patent ductus arteriosus and Eisenmenger physiology. She presented with increasing cyanosis and exercise intolerance which could be explained by a new finding of right to left shunting through an interatrial communication. She was...

  • Inflammo-coagulatory response, extrinsic pathway thrombin generation and a new theory of activated clotting time interpretation. Gil, W. // Perfusion;Jan2001, Vol. 16 Issue 1, p27 

    When blood is subjected to contact with foreign surfaces, as during cardiopulmonary bypass (CPB), the whole body inflammatory response is initiated, resulting in the expression of procoagulant molecules on the vascular endothelium and white blood cells. These surface bound procoagulants...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics