The occurrence of symptomatic CMV infections in heart transplant recipients.

BACKGROUND: Human cytomegalovirus is widely spread in the human population and at present it is the most important clinical agent of opportunistic infections in immunocompromised patients. Bone marrow transplant recipients, solid organ transplant recipients and AIDS patients are at risk of the development of a severe systemic disease. Prompt detection of active infection is essential for early initiation of antiviral therapy. AIM: The aim of our work was to follow the occurrence of symptomatic CMV infection in heart recipients. METHODS: We have used antigenemia assay, PCR and serology methods for the detection of CMV infection in heart transplant recipients. RESULTS: We found that the occurrence of symptomatic CMV infections was lower than the literary data. CONCLUSION: Though a small group of patients was examined, we suppose that this was caused by the careful finding of CMV serostatus of donors and recipients, by using of CMV-seronegative, filtered, or leukocytes-poor blood products, by the examination of blood products and prophylaxis of risk patients, too. (Tab. 1, Ref. 37.).

[Heart transplantation in patients with coronary disease. Preoperative period]. / Transplantácia srdca u pacientov s koronárnou chorobou. Predoperacné obdobie.

The authors report on the current heart transplantation (= HTx) frequency in international as well as domestic--Slovak conditions. The exact criteria for selection of patients who will gain maximum benefit from HTx are given. The alternative procedures namely in patients with progressive coronary artery (ischemic heart) disease, which could substitute or at least postpone HTx until the time when definitive solution of chronic and terminal congestive heart failure will be available are discussed. Apart from that, medical, as well as, psychological problems of pre-operative period and the possibilities of their solution are analysed.

[Heart transplantation in patients with coronary disease. Long-term care of patients after heart transplantation]. / Transplantácia srdca u pacientov s koronárnou chorobou. Dlhodobá starostlivost o pacientov po transplantácii srdca.

The authors present information on basic principles of the long term follow-up of patients after heart transplantation (HTx) and about the present state of HTx programme in Slovakia. "Unique normal" cardiac findings after HTx are described. The most important causes of mortality (infection, rejection, graft vascular disease, malignancy) and morbidity (hypertension, chronic renal insufficiency) are analysed and basic information for rational diagnostic, therapeutic and preventive measures is provided. The authors also discuss long term survival and quality of life after HTx. The paper is dedicated to the large medical community which will take care of the patients after HTx. There is no doubt that the results of clinical transplantology are highly dependent on the level of medical care in wide medical practice.