Postoperative management following heart transplantation.
Advances in surgical techniques, postoperative care, and experience have led to improved outcome in heart transplant patients. Specifically, the use of corticosteroid-free immunosuppression has reduced the risk of infection. The use of pravastatin early after transplantation has led to a decrease in clinically severe rejection episodes, improvement in survival, and reduction in transplant coronary artery disease. Reduction in natural-killer-cell cytotoxicity in the pravastatin-treated patients suggests an adjunct immunosuppressive effect of pravastatin in those patients on CyA-based immunosuppression. Quality of life has also improved in the heart transplant recipient with cardiac rehabilitation demonstrating a beneficial role in the improvement of exercise capacity. Newer immunosuppressive agents and strategies continue to demonstrate benefit in improving survival and the quality of life of the heart transplant recipient.
Kobashigawa
J A
JA
School of Medicine, University of California, Los Angeles, UCLA Heart Transplant Program 90095, USA.
D058186:Acute Kidney Injury / Q000188:drug therapy; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D003714:Denervation; D006084:Graft Rejection / Q000175:diagnosis; D006321:Heart / Q000294:innervation; D016027:Heart Transplantation / Q000534:rehabilitation; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D011182:Postoperative Care; D011183:Postoperative Complications; D011788:Quality of Life; D020123:Sirolimus / Q000627:therapeutic use; D016559:Tacrolimus / Q000627:therapeutic use; D018497:Ventricular Dysfunction, Right / Q000188:drug therapy
D000911:Antibodies, Monoclonal; D009173:Mycophenolic Acid; D020123:Sirolimus; D016559:Tacrolimus