RESUMEN
OBJECTIVE: The aim of this study was to analyze our results as the national reference center of the public health network in Chile. PATIENTS AND METHODS: Retrospective analysis of all transplantations performed between 1998 and 2005 was done and actuarial survival estimates were calculated according to Kaplan-Meier. RESULTS: Heart transplantations were performed in 25 patients of mean age 43 +/- 11.2 years. Eight patients (32%) were transplanted from a national priority list; all patients were under intensive care support with inotropic therapy, 4 were mechanically ventilated, and 1 required an intra-aortic counter pulsation balloon. The average time on the waiting list was 145 days in nonurgent cases and 9.4 days in urgent ones. Perioperative mortality occurred in 1 patient (4%) due to primary graft failure; 2 patients died due to infectious complications during the first year of follow-up; and 1 died due to a non-cytomegalovirus (CMV) infection at 51 months after transplantation. Two patients developed acute rejection with full recovery. The most common morbidities in the current series were hypertension (71%); hyperlipidemia (71%); renal dysfunction (24%); diabetes (10%); and vasculopathy (10%). Actuarial survival rates were 87.2% and 74.7% at 12 and 86 months, respectively. At 7 years follow-up, 20 patients were in New York Heart Association (NYHA) Class I and one Class II. CONCLUSION: Our heart transplantation program showed comparable results in the short and midterm follow-up when compared with other international reports, confirming that heart transplantation is an excellent therapeutic option for patients with end-stage heart failure.
Asunto(s)
Trasplante de Corazón/estadística & datos numéricos , Adulto , Chile , Redes Comunitarias , Trasplante de Corazón/mortalidad , Humanos , Persona de Mediana Edad , Complicaciones Posoperatorias/clasificación , Estudios Retrospectivos , Análisis de Supervivencia , Factores de Tiempo , Insuficiencia del Tratamiento , Resultado del Tratamiento , Listas de EsperaRESUMEN
Platelets aggregate with thrombin-free activated protein C in concentrations higher than physiological levels. Aggregation was dependent on an intact release mechanism since inhibition of aggregation occurred with adenosine or EDTA. However, activated protein C reduced the sensitivity of platelets to aggregate in the presence of thrombin. Probably, activated protein C competes for membrane sites sensitive to thrombin.
Asunto(s)
Glicoproteínas/farmacología , Agregación Plaquetaria/efectos de los fármacos , Trombina/farmacología , Adenosina/farmacología , Sitios de Unión , Ácido Edético/farmacología , Glicoproteínas/antagonistas & inhibidores , Humanos , Proteína CRESUMEN
Platelets aggregate with thrombin-free activated protein C in concentrations higher than physiological levels. Aggregation was dependent on an intact release mechanism since inhibition of aggregation occurred with adenosine or EDTA. However, activated protein C reduced the sensitivity of platelets to aggregate in the presence of thrombin. Probably, activated protein C competes for membrane sites sensitive to thrombin.