Summary:
Aim of the study are description and analysis of the frequency, spectrum and results of „non
cardiac” surgery after heart transplantation (HTx).
Patients: Up to December 1999, 74 patients (9 females) of age 18 - 65 years (median 49) were
followed-up from 1 to 144 months (median 35) after heart transplantation (HTx).
Results: In 10 patients 12 symptomatic non cardiac diseases require surgical procedures. Four
had cholecystolithiasis, one patient cholecystolithiasis with choledocholithiasis. The rest of them
suffered from renal artery occlusion, carcinoma of the cervix uteri, umbilical hernia, ileus, sigmo-
idal carcinoma and two from benign prostatic hyperplasia. In all patients with cholecystolithiasis
laparoscopic cholecystectomy was performed. In the case of concomitant choledocholithiasis en-
doscopic extraction of stones was carried out. In the other patients nephrectomy, cervix uteri
conisation, hernioplasty, adhesiolysis, resection of sigma and transuretral resection of prostatae
were carried out. All procedures were performed by standard methods and no major complicati-
ons were noted.
Conclusion: Non cardiac diseases requiring surgical management after HTx are common. By
steady improvement of survival after HTx increasing incidence of these conditions has to be
expected. The management of them is similar of those in „non transplant” patients. However the
care should be paid to immunosuppressive state and therapy.
Key words:
Heart transplanation - Non cardiac surgery - Cholecystektomy
|