We experienced one of orthotopic cardiac transplantion in a patient with end stage dilated cardiomyopathy.
This 50 year-old female recipient was suffered from NYHA functional class IV cardiac failure and dependent upon intravenous inotropic support for 2 months(recipient category 1). Her peroperative condition was grave with left ventricular ejection
fraction of 20% and estimated systolic pulmonary arterial pressure(from Doppler study) was 50mmHg.
The brain-dead donor was 31 year-old male with head trauma.
The body sizes(weight, height) of the donor/recipient were 70g, 165cm/43kg, 160cm and appropriately overmatched. Preoperatively, identical ABO/Rh blood group(A+) and nonreacting HLA crossmatching were confirmed.
On November 11 1992, cardiac transplantation was performed without complication. Multiple organ procurement team and heart transplantation team were organized the operation schedule appropriately to minimize the ischemic time. The pump time was
126
minites and aortic crossclamping time of recipient heart was 73 minutes and , as a result, total ischemic time of the transplanted heart was 75 minutes.
Postoperatively, the vital signs were stable with minimal inotropic support. The immunosuppressive therapy was commenced from preoperatively and cyclosporine, azathioprine, and corticosteroid were used as a combination therapy as sheduled and
monitored
with blood drug concentration, WBC count, renal function and most importantly regular endomyocardial biopsy.
Now, 5 months after transplantation, the patient is in NYHA functional class II with minimal cardiac drug support. (Korean J Thoracic Cardiovas Surg 1994; 27:224-227)
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