Gallstone Disease in Heart Transplant Recipients

William S. Richardson, MD, Walter J. Surowiec, MD, Kristine M. Carter, MD, Todd P. Howell, MD, Mandeep R. Mehra, MD, John C. Bowen, MD

Disclosures

Annals of Surgery. 2003;237(2) 

In This Article

Methods

Between April 1985 and October 2000, 518 cardiac transplantations were performed at the Ochsner Foundation Hospital. Charts for nine patients were unavailable. From the 509 available charts we determined the results of abdominal ultrasounds and if cholecystectomy was performed before transplant. If cholecystectomy was performed after transplant, the following were noted: age, sex, race, date of cholecystectomy, left ventricular ejection fraction (EF) at time of cholecystectomy, indication for cholecystectomy, procedure for cholecystectomy, operative time, gallbladder pathology, length of hospital stay, complications, readmissions, and deaths.

Compared with other patients undergoing general anesthesia, anesthetic management in patients with good allograft function is similar except that atropine is not used and bagosists (isoproteronol) is kept nearby. The Ochsner Cardiac Transplant Program practices triple-drug immuno-suppression using a calcineurin (cyclosporine, tacrolimus), corticosteroids, and either adjunctive azathioprine or mycophenolate mofetil. Actuarial survival rates in the program are 89% at 1 year, 80% at 3 years, and 75% at 5 years.

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