1. Cardiac Transplantation: An Overview.- 2. Immunogenetics and Immunologic Mechanisms of Rejection.- 3. Medical Therapy Tailored for Advanced Heart Failure.- 4. Ventricular Assistance as a Bridge to Cardiac Transplantation.- 5. Recipient Selection for Cardiac Transplantation.- 6. Donor Selection and Management for Cardiac Transplantation.- 7. Operative Techniques and Early Postoperative Care in Cardiac Transplantation.- 8. Endomyocardial Biopsy: Techniques and Interpretation of Rejection.- 9. Chronic Immunosuppression and the Treatment of Acute Rejection.- 10. Physiology and Hemodynamic Assessment of the Transplanted Heart.- 11. Medical Complications in Patients after Cardiac Transplantation.- 12. Psychiatric Considerations in the Cardiac Transplant Recipient.- Appendices.- I. Pre- and Postoperative Transplant Orders.- II. Pharmacologic Therapy Pre- and Postcardiac.- Transplantation.
Over the past ten years, cardiac transplantation has evolved from an exper imental procedure performed in a handful of university centers to a viable therapeutic modality now performed in more than 150 centers worldwide. The complexity of the procedure, the changing immunosuppressive re gimes, and the follow-up care have necessitated a multidisciplinary ap proach involving a variety of medical, nursing, and social sciences special ties and subspecialties. In addition, health care trainees and referring physicians are increasingly becoming involved in the care of the cardiac transplant recipient. This book does not attempt to be a comprehensive treatise on cardiac transplantation; rather, we hope that it will serve as a manual and guideline for all health professionals involved in cardiac trans plantation. JEFFREY D. HOSENPUD, M.D. Contents Preface v Contributors IX 1. Cardiac Transplantation: An Overview JEFFREY D. HOSENPUD AND ALBERT STARR Immunogenetics and Immunologic Mechanisms of 2. Rejection 15 DOUGLAS J. NORMAN 3. Medical Therapy Tailored for Advanced Heart Failure 33 LYNNE WARNER STEVENSON 4. Ventricular Assistance as a Bridge to Cardiac Transplantation 53 D. GLENN PENNINGTON AND MARC T. SWARTZ Recipient Selection for Cardiac Transplantation 71 5. GEORGE A. PANTELY 6. Donor Selection and Management for Cardiac Transplantation 85 JEFFREY SWANSON AND ADNAN COBANOGLU 7. Operative Techniques and Early Postoperative Care in Cardiac Transplantation 95 ADNAN COBANOGLU Endomyocardial Biopsy: Techniques and Interpretation of 8.
This is a practical manual (including protocols) that discusses aspects of cardiac transplantation important not only for the surgeon, but also for clinical staff, nurses, psychiatrists, and others involved in care of the cardiac transplant patient. The book gives an overview and is not limited to surgical procedures.