特集「心臓移植と感染症」
心臓移植後急性期の感染症管理
キーワード:
heart transplantation,
infection,
left ventricular assist device,
antibiotics,
negative pressure wound therapy
2018 年 53 巻 1 号 p. 15-21
詳細
2018 年 53 巻 1 号 p. 15-21
Heart transplantation is the gold standard of therapy for end-stage heart failure. Because of the extreme shortage of donor hearts, the need for prolonged support with a continuous-flow ventricular assist device (VAD) has increased and more patients are at risk for VAD-specific and VAD-related infections. Although the duration of VAD support prior to heart transplantation does not directly affect the outcomes of heart transplantation, the presence of active VAD-specific infections is an independent risk factor for increased severity of early postoperative infection in heart transplantation recipients. To date, there is no ideal prophylactic antibiotic regimen for patients undergoing heart transplantation after long-term VAD support. However, if infecting organisms are isolated from the recipient before transplantation, then the perioperative antibiotics regimen should be tailored to treat the isolated microorganisms.
