Perfusion for cardiac transplantation

Abstract

The optimum support of patients undergoing cardiac or cardiopulmonary transplantation requires particular consideration of various aspects of perfusion management. Many of these patients have chronic low cardiac output and consequent renal, hepatic and pulmonary dysfunction. Cyclosporin A is now the cornerstone of most immunosuppressive regimes and a major side effect of this drug is it's nephrotoxicity. ¹ A technique is described which is designed to optimize perfusion support for this group of patients.

Cardiac transplantation does not usually present a difficult technical surgical challenge. The subsequent success of the procedure depends largely on appropriate donor and recipient selection and attention to the finer points of patient management, and in particular the fine tuning of immunosuppressive therapy. The provision of optimum perfusion support has a substantial influence on early postoperative progress, particularly in those patients with preoperative multiorgan failure, secondary to a low cardiac output.