title: Gastrointestinal complications after human transplantation and mechanical heart replacement.
abstract: One hundred fifty-three patients underwent 159 heart transplants; 7 of these patients received 8 artificial hearts used as a bridge before implantation. The 1-year survival rate was 81 percent. One hundred forty gastrointestinal complications developed in 70 patients. Thirty-eight operations were required. Twenty-nine were intraabdominal operations. Of these, 22 were elective and 7 were emergency procedures. Five of the seven patients who underwent emergency procedures died, for an overall total mortality rate of 17 percent for major intraabdominal interventions. There were no complications or deaths in patients who underwent elective procedures. Major elective intraabdominal surgical interventions can be safely carried out in heart transplant patients. Repeated physical examination, aggressive use of endoscopy and imaging techniques, sound surgical judgement and a mutual relationship of trust and respect between cardiac and general surgeons are keys to a successful outcome.
authors.affiliation: Department of Surgery, University of Arizona Health Sciences Center, Tucson 85724.
authors.forename: H V
authors.initials: HV
authors.lastname: Villar
authors.forename: D D
authors.initials: DD
authors.lastname: Neal
authors.forename: M
authors.initials: M
authors.lastname: Levinson
authors.forename: J M
authors.initials: JM
authors.lastname: Fuller
authors.forename: R W
authors.initials: RW
authors.lastname: Emery
authors.forename: A R
authors.initials: AR
authors.lastname: Graham
authors.forename: J
authors.initials: J
authors.lastname: Copeland
authors.forename: M J
authors.initials: MJ
authors.lastname: Rhenman
authors.forename: J G
authors.initials: JG
authors.lastname: Copeland
mesh_terms: D004630:Emergencies; D004935:Esophageal Diseases / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D005767:Gastrointestinal Diseases / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D016027:Heart Transplantation; D006355:Heart-Lung Machine; D006801:Humans; D007165:Immunosuppression Therapy; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality