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Series of complications after heart transplantation – a case report


Authors: T. Honěk 1,2;  J. Krejčí 1,2;  P. Němec 2,3;  Z. Adam 4;  V. Žampachová 5;  V. Feitová 6;  L. Špinarová 1
Authors place of work: I. interní kardioangiologická klinika LF MU a FN u sv. Anny v Brně 1;  Mezinárodní centrum klinického výzkumu, FN u sv. Anny v Brně 2;  Centrum kardiovaskulární a transplantační chirurgie, Brno 3;  Interní hematologická a onkologická klinika LF MU a FN Brno 4;  I. patologicko-anatomický ústav, LF MU a FN u sv. Anny v Brně 5;  Klinika zobrazovacích metod LF MU a FN u sv. Anny v Brně 6
Published in the journal: Kardiol Rev Int Med 2014, 16(6): 476-480
Category: Cardiology Review

Summary

Orthotopic heart transplantation is an established method of treatment for patients with end‑stage heart failure, which improves the survival of these patients. The use of immunosuppressive therapy comes at the price of a number of potential risks, the most serious being infectious complications. Our case report describes a patient with heart failure on the basis of primary amyloidosis who underwent cardiac transplantation. Hemato‑ oncological curative treatment was planned after transplantation, but has not been applied due to the complete remission of the primary disease. In the early post‑transplant period, the patient experienced a number of complications, the most serious being invasive pulmonary aspergillosis. This infection was successfully controlled using voriconazole, and 28 months after heart transplantation the patient is now in good clinical condition with no signs of active infection.

Keywords:
orthotopic heart transplantation –  primary amyloidosis –  endomyocardial bio­psy –  invasive pulmonary aspergillosis


Zdroje

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3. Krejčí J. Heart failure in AL amyloidosis –  Are we still helpless? Cor et Vasa 2013; 55: 330– 332.

4. Kristen AV, Sack FU, Schonland SO et al. Staged heart transplantation and chemotherapy as a treat­ment option in patients with severe cardiac light‑chain amyloidosis. Eur J Heart Fail 2009; 11: 1014– 1020. doi: 10.1093/ eurjhf/ hfp121.

5. Dey BR, Chung SS, Spitzer TR et al. Cardiac transplantation followed by dose‑intensive melphalan and autologous stem‑ cell transplantation for light chain amyloidosis and heart failure. Transplantation 2010; 90: 905– 911. doi: 10.1097/ TP.0b013e3181f10edb.

6. Husain S, Mooney ML, Danziger‑ Isakov L et al. A 2010 Working formulation for the standardization of definitions of infections in cardiothoracic transplant recipients. J Heart Lung Transplant 2011; 30: 361– 374. doi: 10.1016/ j.healun.2011.01.701.

7. Desoubeaux G, Bailly É, Chandenier J. Dia­gnosis of invasive pulmonary aspergillosis: updates and recommendations. Med Mal Infect 2014; 44: 89– 101. doi: 10.1016/ j.medmal.2013.11.006.

8. Walsh TJ, Anaissie EJ, Denning DW et al. Treatment of Aspergillosis: Clinical Practice Guidelines of the Infectious Diseases Society of America. Clin Infect Dis 2008; 46: 327– 360. doi: 10.1086/ 525258.

9. Ráčil Z, Mayer J, Kocmanová I et al. Léčba invazivní aspergilózy –  doporučení odborných společností. Vnitř Lék 2008; 54: 1187– 1194.

10. Šajgalík P, Špinarová L, Hude P et al. Pacientka po transplantaci srdce s plicní formou invazivní aspergilózy. Kardiol Rev 2012; 14: 130– 132.

11. Kumar S, Dispenzieri A, Lacy MQ et al. Revised prognostic staging system for light chain amyloidosis incorporating cardiac biomarkers and serum free light chain measurements. J Clin Oncol 2012; 30: 989–995. doi: 10.1200/JCO.2011.38.5724.

Štítky
Paediatric cardiology Internal medicine Cardiac surgery Cardiology

Článok vyšiel v časopise

Cardiology Review

Číslo 6

2014 Číslo 6
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