Hematologic aspects of heart transplantation
Goncalvesová, E.; Fabián, J.; Pacák, J.
Bratislavske Lekarske Listy 98(5): 253-257
1997
ISSN/ISBN: 0006-9248 PMID: 9296830 Document Number: 476922
Heart transplantation is an accepted therapeutic method for end-stage heart failure. The aim of the presented paper is to provide a short review of haematologic problems of heart transplantation. Haemostatic disorders, cytopenias and lymphoproliferative diseases are the most frequent haematologic complications of this highly sophisticated procedure. Perioperative bleeding tendency is due to cardiopulmonary bypass, both qualitative and quantitative platelet disorders and hyperfibrinolysis are the main causes. Incidence of cytopenias (mono- and/or bi- and/or tricytopenia) reaches up to 70%. They are multifactorial as to etiology and coincidence with viral infection, antimicrobial and immunosuppressive therapy. Lymphoproliferative disease affects about 1.2% of patients during the first year after transplantation. Posttransplant lymphoproliferative diseases are highly variable as to manifestation and prognosis-ranging from indolent course to rapid, aggressive growth. Routine cytostatic therapy is generally ineffective. Crucial therapeutic measure is to turn off immunosuppressive therapy. (Tab. 3, Fig. 2, Ref. 41).