Vnitr Lek 2000, 46(11):745-749

["Non-cardiac" surgery in patients after heart transplantation].

J Fabián, E Goncalvesová, J Stencl: Slovenský ústav srdcových a cievnych chorôb, Bratislava, Slovenská republika.

UNLABELLED: 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, sigmoidal carcinoma and two from benign prostatic hyperplasia. In all patients with cholecystolithiasis laparoscopic cholecystectomy was performed. In the case of concomitant choledocholithiasis endoscopic 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 complications 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.