Abstract
We present a summary of the intensive care provided to 20 patients who underwent heart transplantation at the National Cardiovascular Center. Nineteen patients suffered from dilated cardiomyopathy, of which 18 had been supported by a left ventricular assist system. In the ICU, cardiac pacing was applied in all patients, with 9 patients requiring isoproterenol infusion in addition, to maintain an appropriate heart rate. All patients received infusions of low-dose of dopamine and atrial natriuretic peptide. The immunosuppression regimen consisted of cyclosporine (or tacrolimus), mycophenolate mofetil, and methylprednisolone in the patients with normal hepatorenal function. Earliest removal of catheters and tubes was always attempted at the ICU. Most of the patients were discharged from the ICU and transferred to the ward on postoperative day 8, without any serious events. In addition to the conventional intensive care provided to patients undergoing open heart surgery, management of the denervated heart and preservation of renal function are important targets of acute care in patients undergoing heart transplantation.
