This is a comprehensive translational reference covering a range of topics within heart transplantation. Including review of the procedure itself, preoperative requirements, potential complications and follow-up with the most up-to-date research and literature review, it introduces the embryology, anatomy, physiology, pathology and cardio-immunology of the heart. It also delves into other aspects of heart transplantation including organ procurement, religious aspects, the ethical issues that can emerge prior or during the surgery and discussion of the continued development of artificial hearts. The book explores multiorgan transplantation and their outcomes and complications.
Heart Transplantation discusses the topic using illustrations and charts to aid understanding, allowing readers to gain a full understanding of the whole procedure easily. A list of practical surgical questions are presented at the end of each chapter to encourage the reader to challenge their understanding of the topic. With an emphasis on an interconnected approach to studying heart transplantation, this book presents a novel approach to educating surgeons in this challenging area of surgery. It is therefore an important addition to the literature for all involved in the management of heart transplantation from surgical residents to surgical nurses, cardiologists, anesthesiologists and experienced cardiac surgeons.
Author(s): Hashim Talib Hashim, Naseer Ahmed, Giuseppe Faggian, Martí Manyalich, Francesco Onorati
Publisher: Springer
Year: 2023
Language: English
Pages: 313
City: Cham
Preface
Contents
Anatomy of the Heart
1 Introduction
2 Structure of the Heart
3 Cardiac Chambers
4 Cardiac Valves
5 The Great Vessels
6 The Conduction System of the Heart
7 Coronary Circulation
8 Coronary Arteries
9 Coronary Veins
References
Physiology of the Heart
1 Introduction
2 Relationships of the CVS to Homeostasis
3 The Cardiac Muscles
4 Coronary Circulation
5 Mechanism of the Beating of the Heart
6 Heart Conduction System
7 Electrical Activity of the Heart
8 Control of the Heart by Sympathetic and Parasympathetic Nerves
9 ECG: Recording the Heart’s Electrical Activity
10 Heart Sounds
11 Cardiac Output (CO)
12 The Central Venous Pressure (CVP)
References
Embryology of the Heart
1 Introduction
2 Primary Heart Tube Formation
3 Cardiac Looping
4 Cardiac Separation
4.1 Atrial Separation and Canal Separation
4.2 Ventricular Separation
4.3 Outflow Tract Separation
5 Development of Great Arteries
6 Development of the Conductive System of the Heart
7 Development of Semilunar Valves
8 Development of the Venous System
9 Development of Superior Venal Cava
9.1 Development of Coronary Arteries
References
The Pathological Changes Seen in Cardiac Diseases Indicated for Transplantation
1 Introduction
2 Morphological Changes of the End-Stage Heart Failure
3 Cellular and Molecular Changes in Heart Failure
3.1 Cardiac Remodeling and Hypertrophy
3.2 Inflammation and Heart Failure
3.3 Nitric Oxide in Heart Failure
3.4 Fibrosis in Heart Failure
3.5 Beta Adrenergic Stimulation and Excitation–Contraction Mismatch
3.6 T-Tubule Remodeling
3.7 Capillary Density
3.8 DNA Changes and Genetic Activation of Fetal Genes
3.9 Autophagy Role in Heart Failure
4 Hemodynamic Changes of Heart Failure
5 Pulmonary Capillary Wedge Pressure (PCWP) and Central Venous Pressure (CVP)
6 Ischemic Cardiomyopathy
7 Dilated Cardiomyopathy
8 Hypertrophic Cardiomyopathy
9 Restrictive Cardiomyopathy
9.1 Lysosomal Storage Diseases
10 Fatty Acid Oxidation Disorder
11 Mitochondrial Disease
12 Arrhythmias
13 Congenital Heart Diseases
References
Cardioimmunology and Heart Transplantation
1 Introduction
2 The Population of Immune Cells in the Heart
3 The Immune System’s Role in Heart Disease
4 Heart Transplant Cardioimmunology
5 Immunology of Transplant Rejection
References
Heart Failure Outcomes and Management
1 Introduction
2 Outcomes and Controlling the Outcomes
References
Donor Management and Organ Procurement
1 Types of Donors for Heart Transplantation
2 Assessment of the Donor Prior to Heart Procurement
3 Current Approaches in Retrieval and Heart Preservation
3.1 Cold Ischemic Storage
3.2 Ex-Vivo Normothermic Preservation
References
Heart Transplantation Procedure
1 Introduction
2 Epidemiology
3 Indication for Heart Transplantation
4 Contraindication for Heart Transplantation
5 Donor Selection
6 Recipient Preparation
7 Donor Preparation
8 Donor Risk Score
9 Waiting List
10 Selection of Operation Time
11 Anesthesia
12 Monitoring of the Recipient
13 Induction of Anesthesia
14 Coagulation Management
15 Maintenance of Anesthesia
16 Donor Heart Retrieval
17 Cold Ischemic Time
18 Recipient Cardiectomy
19 Implantation
20 Heart injury
References
Complications and Follow Up
1 Introduction
2 Transplant Rejection
3 Etiology for Heart Transplant Rejection (HTR) Varies Based on the Onset of Rejection
4 Heart Transplant Rejection
5 Possible Alternatives
6 Histopathology
7 Histological Grading
8 Prevent Rejection
9 Acute Cellular Rejection
10 Antibody-Mediated Rejection
11 Long-term Management
12 Diagnosis
13 Management of CVA
14 Early Graft Dysfunction (Primary Graft Dysfunction)
15 Follow Up
References
Outcomes and Impact on Life Quality
1 Chronic Allograft Rejection
1.1 Pathogenesis
1.2 Clinical Features and Diagnosis
1.3 Therapy
2 Malignancy
2.1 Skin Cancers
2.2 Post-Transplant Lymphoproliferative Disorders
2.3 Other Solid Tumors
2.4 Cancer Prevention
3 Chronic Kidney Disease (CKD)
3.1 Pathogenesis
3.2 Measures of Prevention
3.3 Outcomes
4 Metabolic Disorders After Heart Transplant
4.1 Diabetes
4.2 Corticosteroids Side Effects
5 Quality of Life After Heart Transplant
References
Heterotopic Heart Transplantation
1 Introduction
2 Historical Perspectives
3 Indications of HHT
4 Complications of HHT
5 Postoperative Care in HHT
6 Statistical Comparison Regarding HHT and OHT
7 The Surgical Technique of HHT
7.1 Harvesting the Donor Heart
7.2 Donor Heart Preparation
7.3 Preparation of the Recipient Thorax
7.4 Recipient Cannulation and Cardioplegia
7.5 The Atrial Anastomosis
7.6 The Aortic Anastomosis
7.7 Anastomosing the Graft Main PA with Recipient RA
7.8 The Superior Vena Cava Anastomosis
7.9 Post-Anastomosis Procedures
References
Artificial Heart, Cellular, Regenerative, and Xenotransplantation
1 Introduction
2 Initial Clinical Indication for the Use of a Permanent Artificial Heart
3 Heart–Lung Machine
4 Mechanical Hearts
5 Carmat Bioprosthetic Heart
6 Soft Artificial Heart
7 Hybrid Assistive Devices
8 Cellular Heart Implantation
9 Problems in Skeletal Myoblast Transplantation
10 The Second Generation: Blood and Bone Marrow-Derived Cells
11 Xenotransplantation Heart Transplant
References
Multi-organ Transplantation
1 Introduction
2 Background of Organ Transplantation
3 The History of Organ Transplantation
4 Organ Transplantation Records
5 Modes of Transplant
6 Multi-organ Transplants
7 Indication for Heart–Liver Transplantation
8 Patient Selection
9 Advantages of Multi-organ Transplants for the Candidates
10 Steps to Standardize Multi-organ Transplant at the Transplant Centers
11 Recommendations for Multi-organ Transplant Standardization
12 Alternatives of Transplant
References
Ethical Issues of Heart Transplantation
1 Introduction
2 What is the “Dead Donor Rule”?
3 The Types of Consent
4 The Principles of Informed Consent
5 The Ethical Arguments in Favor of Presumed Consent
6 The Ethical Arguments Against Presumed Consent
7 Arguments Supporting Financial Incentives
8 Innocent Heart Sentenced to Life in Cheney
References
Cultural and Religious Aspects of Heart Transplantation
1 Introduction
2 Cultural and Religious Aspects of Heart Transplantation (Islamic Perspective)
2.1 Introduction
2.2 Islamic Perspective of Heart Transplantation
2.3 Contrary Opinions
2.4 Supportive Opinion
2.5 Basic Concept Behind the Permissibility of Organ Transplantation
2.6 Adoption of the Lesser-of-Two Evils
2.7 List of Some of the Rulings (Fatwas)
3 Donation and Transplantation from the Cultural and Religious Perspective of Buddhism
4 Donation and Transplantation from a Cultural and Religious Perspective in China
4.1 Introduction
4.2 Influence of Chinese Traditional Values and Customs on Organ Donation
4.3 Influence of People’s Perception of Mortality on Organ Donation and Transplantation
4.4 Advancement of People’s Perception toward Organ Donation
4.5 Cultural and Religious Factors as Facilitators
4.6 Conclusion
5 Cultural and Religious Aspects of Heart Transplantation (Catholic Perspective)
5.1 Introduction
5.2 Doctrine of the Catholic Church in Relation to Brain Death and Organ Transplantation
References
Bridging Strategies for Heart Transplantation
1 The Total Artificial Heart (TAH)
2 Left Ventricular Assist Device (LVAD)
3 IABP (Intra-Aortic Balloon Pump)
4 ECMO (Extracorporeal Membrane Oxygenation)
5 Long-Term Milrinone
References
Heart Memory and Feelings
1 Introduction
2 Heart Memory
3 The Role of Genes
4 The Role of Nerves
References
Index
