Subject(s)
Blood Loss, Surgical/prevention & control , Cardiac Valve Annuloplasty , Coronary Artery Disease , Heart Valve Diseases , Myocardial Revascularization , Perioperative Care/methods , Aged , Aged, 80 and over , Cardiac Valve Annuloplasty/adverse effects , Cardiac Valve Annuloplasty/methods , Coronary Artery Disease/complications , Coronary Artery Disease/surgery , Female , Heart Valve Diseases/complications , Heart Valve Diseases/surgery , Humans , Male , Monitoring, Intraoperative/methods , Myocardial Revascularization/adverse effects , Myocardial Revascularization/methods , Outcome and Process Assessment, Health Care , Platelet Aggregation Inhibitors/administration & dosage , Platelet Aggregation Inhibitors/adverse effects , Risk Adjustment , Risk Factors , Survival Rate , Treatment OutcomeSubject(s)
Heart Transplantation/legislation & jurisprudence , Kidney Transplantation/legislation & jurisprudence , Liver Transplantation/legislation & jurisprudence , Multiple Organ Failure/surgery , Pancreas Transplantation/legislation & jurisprudence , Tissue Banks/organization & administration , Tissue Donors/legislation & jurisprudence , Tissue and Organ Procurement/legislation & jurisprudence , Humans , Tissue Banks/legislation & jurisprudence , Tissue Banks/standards , Tissue Donors/supply & distribution , Tissue and Organ Procurement/methods , Tissue and Organ Procurement/standards , USSRABSTRACT
From October, 1986 to February, 1990 eighty-five potential donors with death of the brain were examined at the Scientific Research Institute of Transplantology and Artificial Organs, USSR Ministry of Public Health. Thirty of them were used as heart donors in orthotopic transplantation of the heart; 24 (80%) were males and 6 (20%) females. The cause of death of the brain was craniocerebral trauma in 13, brain tumor in 9, hemorrhage into the brain tissue in 7 cases, and gunshot injury to the skull with damage to the brain in one case. In appraisal of the donors; in 8 (26.7%) cases the ECG did not differ from the initial one, in another 8 cases (26.7%) the ECG demonstrated electrolyte disorders in the form of hypokalemia , still in another 8 cases right bundle-branch block was encountered, in 2 (6.65%) the ECG showed transient form of cardiac fibrillation, in still another 2 cases I-II degree atrioventricular block was found, in one (3.3%) right and left bundle-branch block was demonstrated, and in one case the ECG showed diminished nutrition in the region of the posterior left-ventricular wall. All donors had disorders of homeostasis characteristic of patients with death of the brain, while the condition of hemodynamics conformed to these disorders. It is concluded on the basis of the obtained data that electrocardiographic monitoring is expedient and that it plays a role in complex appraisal of a potential heart donor.
Subject(s)
Brain Death/physiopathology , Electrocardiography , Heart Transplantation/methods , Heart/physiopathology , Tissue Donors , Tissue and Organ Procurement/methods , Adolescent , Adult , Child , Female , Homeostasis/physiology , Humans , MaleABSTRACT
The article discusses the first clinical experience of the donor maintenance of the program of heart transplantation. Under analysis are etiology and terms of the process of death of the brain in 65 potential donors. The authors propose a scheme of the three-stages assessment of fitness of his heart for transplantation. Specific features of intensive therapy of the donors are considered. Twenty donors were used for clinical transplantations of the heart, in 18 cases (90%) satisfactory recovery of functions of the transplanted heart was noted.
