The Journal of Thoracic and Cardiovascular Surgery, Vol 98, 506-509, Copyright © 1989 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Infections in mortally ill cardiac transplant recipients
J Hsu, BP Griffith, RD Dowling, RL Kormos, JS Dummer, JM Armitage, M Zenati and RL Hardesty
Department of Surgery, University of Pittsburgh, PA 15261.
A total of 351 cardiac transplantations performed between June 1, 1980, and
Sept. 30, 1987, were reviewed to determine if infectious complications were
more frequent in those patients requiring preoperative intravenous
inotropic support, placement of an intraaortic balloon pump, or mechanical
support with a left ventricular assist device or total artificial heart.
One hundred forty-nine transplants (45%) were performed in these mortally
ill patients. There was no statistically significant difference between
patients with and without infection within each support group for the
following: the number of in- patient days awaiting a donor heart, the
number of days receiving support, the percent of patients with preoperative
tracheal intubation, the length of the operation, and the percent of
patients requiring reoperation for bleeding. The need for invasive methods
of support (intraaortic balloon pump, left ventricular assist device, or
total artificial heart) in patients awaiting heart transplantation
increases the prevalence of perioperative nonviral infection. Preoperative
mechanical support with a left ventricular assist device or total
artificial heart significantly increases the risk of infection-related
mortality.