[Early complications and their treatment after heart transplantation in Hungary--experience of the first 16 years].
Heart transplantation is the most successful current long-term therapy of end stage cardiac failure.


OBJECTIVE
In order to improve the results of the Hungarian heart transplantation activity, all data from the first 16 years were retrospectively examined and matched with the relevant literature.


METHODS
Between January 1992 and December 2007, 127 heart transplantations were performed in 125 patients in Hungary. Above the documentation of the Department of Cardiovascular Surgery, Semmelweis University, the archives of the Institute of Forensic Medicine, Semmelweis University, the Registry of Hungarian National Blood Transfusion Service, Organ Coordination Office and the data of the Gottsegen György National Institute of Cardiology were used.


RESULTS
Early mortality has been approaching the international level recently. Graft failure was the primary cause of death in the Hungarian practice as well, followed by infection, uncontrollable bleeding during surgery and multiorgan failure. In one case successful acute retransplantation was performed, but the most effective, ventricular assist device therapy is completely missing from the armamentarium. Excellent results were achieved with medical treatment against acute rejection such as written in the international literature.


CONCLUSIONS
For the sake of developing, regular usage of assist device therapy in Hungary is a prominent task. Development and application of standard protocols providing better quality in organ donor treatment and donation management have to be pressed.
Friedrich
Orsolya
O
Semmelweis Egyetem, Altalános Orvostudományi Kar Er- és Szívsebészeti Klinika Budapest John Radcliff Hospital Oxford Nagy-Britannia. orsolyafriedrich@hotmail.com
Moravcsik
Endre
E
Gyöngy
Tibor
T
Hüttl
Tivadar
T
Hartyánszky
István
I
Petrohai
Agnes
A
Bodor
Elek
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000401:mortality; D005260:Female; D006084:Graft Rejection / Q000401:mortality / Q000517:prevention & control*; D006085:Graft Survival; D016027:Heart Transplantation / Q000009:adverse effects* / Q000401:mortality / Q000706:statistics & numerical data*; D006354:Heart, Artificial; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007239:Infections / Q000209:etiology / Q000401:mortality; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology / Q000401:mortality; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality* / Q000517:prevention & control*; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D009927:Tissue and Organ Procurement / Q000592:standards; D016896:Treatment Outcome; D055815:Young Adult
D007166:Immunosuppressive Agents