Başkent Üniversitesi Yayınları

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    Gender-Based Analysis of Outcome After Heart Transplantation
    (Başkent Üniversitesi, 2012-08) Eifert, Sandra; Meiser, Bruno; Kaczmarek, Ingo; Beiras-Fernandez, Andres; Bigdeli, Amir Khosrow; Horster, Sophia; Nickel, Thomas; Kofler, Sieglinde
    Objectives: Gender differences between donors and recipients might have an effect on outcome after heart transplantation. Literature and registries reveal controversial results. We reviewed 1000 heart transplantations at our center focusing on the influence of gender differences on short- and long-term outcome after heart transplantation. Materials and Methods: We performed a retrospective analysis of 1000 (960 primary and 40 redo-heart transplantations) between August 1981 and July 2008. In contrast to other studies, the data for gender differences (donor gender and recipient gender) were evaluated for recipient survival and survival conditional to early mortality. Results: Female donors are significantly older than male donors (females, 36.5 ± 14.5 years; males, 31.2 ± 13.8 years). One-year survival was significantly inferior in male recipients receiving female donor hearts (mR/fD: 73.7%) compared to females receiving male donor organs (fR/mD: 90.9%) (P = .045). Univariate analysis revealed that, for recipients who survived > 1 year, survival at 10 years was significantly greater for female donors and female recipients (90%) than it was for male donors and male recipients (72%; P = .034). Multivariate analysis showed that the gender combination with female donors and female recipients was an independent indicator for greater long-term survival (P = .04). Conclusions: The gender combination of female donors and male recipients had a greater risk for early mortality after heart transplantation, and the combination of male donors and female recipients resulted in favorable short-term outcomes. In long-term follow-up, recipients of hearts from female donors had better survival, especially female recipients.
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    ECMO After Prolonged Cardiopulmonary Resuscitation as a Successful Bridge to Immediate Cardiac Retransplant in a 6-Year-Old Girl
    (Başkent Üniversitesi, 2012-04) Bigdeli, Amir Khosrow; Kaczmarek, Ingo; Sodian, Ralf; Schmitz, Christoph; Michel, Sebastian; Beiras-Fernandez, Andres; Deutsch, Marcus-André
    Heart failure, life-threatening arrhythmias, and sudden cardiac death are common complications in patients with advanced chronic cardiac allograft rejection—the major limiting factor of long-term survival after heart transplant. In patients with sustained cardiorespiratory arrest refractory to cardiopulmonary resuscitation extracorporeal membrane oxygenation therapy is a therapeutic option. We report the case of a 6-year-old girl with severe chronic allograft vasculopathy who was successfully bridged to cardiac retransplant through extracorporeal membrane oxygenation therapy after prolonged cardiopulmonary resuscitation. Our case demonstrates extracorporeal membrane oxygenation as a rescuing therapeutic option in high-risk, bridge-to-transplant patients, with cardiac arrest. Even after prolonged cardiopulmonary resuscitation, there were no neurologic events, and our patient recovered without any neurologic damage.
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    Combination Antifungal Therapy for Invasive Pulmonary Aspergillosis in a Heart Transplant Recipient
    (Başkent Üniversitesi, 2011-08) Beiras-Fernandez, Andres; Kaczmarek, Ingo; Reichart, Bruno; Ueberfuhr, Peter; Michel, Sebastian; Nickel, Thomas; Bigdeli, Amir K.
    Invasive pulmonary aspergillosis is a severe complication after solid organ transplant, with a high mortality rate. We present a 45-year-old male heart transplant recipient who developed fever, progressive worsening of dyspnea, and productive cough without response to antibiotics. Diagnosis of invasive pulmonary aspergillosis was made based on clinical, laboratory, and radiographic findings. The patient was treated successfully with combined antifungal therapy (voriconazole and micafungin). This case report highlights the importance of a high degree of clinical suspicion to allow curative treatment of invasive aspergillosis and the efficiency of new antifungal drugs.