title: Acute heart transplant graft failure in association with hyperosmolar hyperglycemia state.
abstract: We report a 38-year-old male with end-stage ischemic cardiomyopathy requiring left ventricular assist device placement, followed by orthotopic heart transplantation, who presented 18 months post-orthotopic heart transplant with acute graft failure with estimated left ventricular ejection fraction of 5% to 10%, in association with a glucose level of 550 mg/dL, and hemoglobin A1C of 13.8% and a negative pathology for a graft cellular and humoral rejection and no vasculaopthy. His left ventricular ejection fraction improved significantly to 40% to 45% within three days of optimal glucose control.
authors.affiliation: Division of Cardiovascular Disease, University of Texas Medical Branch, Galveston, Texas.
authors.forename: Kamel
authors.initials: K
authors.lastname: Sadat
authors.forename: Mohamed
authors.initials: M
authors.lastname: Morsy
authors.forename: Wissam I
authors.initials: WI
authors.lastname: Khalife
mesh_terms: D000208:Acute Disease; D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000628:therapy*; D016027:Heart Transplantation; D006352:Heart Ventricles; D006353:Heart-Assist Devices; D006801:Humans; D006943:Hyperglycemia / Q000150:complications* / Q000628:therapy*; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D008297:Male; D017202:Myocardial Ischemia / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D055031:Primary Graft Dysfunction / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D007004:Hypoglycemic Agents