Bodor E

Aortic coarctation reconstructed by resection and homograft replacement in the 1950s: long-term outcome 40 years after operation

Since the first successful repair of aortic coarctation by Dr Clarence Crafoord in 1945, there are few data regarding late follow-up of homografts in this position. Between 1957 and 1959, 7 patients underwent surgical correction of aortic coarctation by Professor József Kudász at the Department of Cardiovascular Surgery, Semmelweis University, using freeze-dried aortic homograft. We were able to locate 4 of these patients and found no significant complications due to the operation. We report on this 40-year follow-up of implanted aortic homograft.

Early complications and their treatment after heart transplantation in Hungary – experiences of the first 16 years

UNLABELLED Heart transplantation is the most successful current long-term therapy of end stage cardiac failure. AIM In order to improve the results of the Hungarian heart transplantation activity, all data from the first 16 years were retrospectively examined and matched with the relevant literature. METHODS Between January 1992 and December 2007, 127 heart transplantations were performed in 125 patients in Hungary. Above the documentation of the Department of Cardiovascular Surgery, Semmelweis University, the archives of the Institute of Forensic Medicine, Semmelweis University, the Registry of Hungarian National Blood Transfusion Service, Organ Coordination Office and the data of the Gottsegen György National Institute of Cardiology were used. RESULTS Early mortality has been approaching the international level recently. Graft failure was the primary cause of death in the Hungarian practice as well, followed by infection, uncontrollable bleeding during surgery and multiorgan failure. In one case successful acute retransplantation was performed, but the most effective, ventricular assist device therapy is completely missing from the armamentarium. Excellent results were achieved with medical treatment against acute rejection such as written in the international literature. CONCLUSIONS For the sake of developing, regular usage of assist device therapy in Hungary is a prominent task. Development and application of standard protocols providing better quality in organ donor treatment and donation management have to be pressed.

[The first successful combined heart-kidney transplantation in Hungary].

Combined heart-kidney transplantation has become a new therapeutic solution for patients with coexisting, irreversible heart and kidney failure. Though this combined approach has several theoretical advantages over sequential transplantation, it remains to be established whether it has a jeopardizing impact on patient and graft outcome. The authors report their experience of the first successful combined heart-kidney transplantation in Hungary from a single donor and review the literature in order to clarify this issue. Young male patient candidate for heart transplantation was suffering from concurrent end stage kidney disease. Donor was selected on the basis of weight and size matching, AB0 compatibility and negative T-cell cross-match. The heart was grafted first, and after the hemodynamic stabilization kidney from the same donor was transplanted. The surgical procedure was uneventful. Heart and kidney function recovered quickly, and the patient is doing very well with good cardiac and renal function even a year following the double organ transplantation. The first Hungarian experience showed that combined heart-kidney transplantation is a therapeutic solution for patients with end stage heart and kidney failure. The lower rate of rejection compared to single heart or kidney transplantation, known from the literature as well, supports their current approach to immunosuppression.

Role of heart transplantation in pediatric heart surgery. The first successful pediatric heart transplantation in Hungary

7-year-old boy, who underwent aortic valve replacement two years previously, suffered from idiopathic dilated cardiomyopathy. Because of poor condition (NYHA-IV), heart transplantation was performed on 18th October 2007. It was the first pediatric heart transplantation in Hungary. It was an uneventful early postoperative period, 6 months after the operation he is doing well, no biopsy-proven and tissue Doppler echocardiography (TDI-derived velocities measurement) rejection was detected. The immunosuppression was based on triple-drug therapy (tacrolimus+mycophenolate mofetil+corticosteroid) with use of induction therapy with interleukin-2 receptor blocker (basiliximab).

A szívtranszplantáció helye a gyermekszívsebészetben. Az első sikeres gyermekszív-átültetés Magyarországon@@@The role of heart transplantation in pediatric heart surgery. The first pediatric heart transplantation in Hungary

7-year-old boy, who underwent aortic valve replacement two years previously, suffered from idiopathic dilated cardiomyopathy. Because of poor condition (NYHA-IV), heart transplantation was performed on 18th October 2007. It was the first pediatric heart transplantation in Hungary. It was an uneventful early postoperative period, 6 months after the operation he is doing well, no biopsy-proven and tissue Doppler echocardiography (TDI-derived velocities measurement) rejection was detected. The immunosuppression was based on triple-drug therapy (tacrolimus+mycophenolate mofetil+corticosteroid) with use of induction therapy with interleukin-2 receptor blocker (basiliximab).

A szívtranszplantáció helye a gyermekszívsebészetben. Az elso sikeres gyermekszív-átültetés Magyarországon

7-year-old boy, who underwent aortic valve replacement two years previously, suffered from idiopathic dilated cardiomyopathy. Because of poor condition (NYHA-IV), heart transplantation was performed on 18th October 2007. It was the first pediatric heart transplantation in Hungary. It was an uneventful early postoperative period, 6 months after the operation he is doing well, no biopsy-proven and tissue Doppler echocardiography (TDI-derived velocities measurement) rejection was detected. The immunosuppression was based on triple-drug therapy (tacrolimus+mycophenolate mofetil+corticosteroid) with use of induction therapy with interleukin-2 receptor blocker (basiliximab).

The role of heart transplantation in pediatric heart surgery. The first pediatric heart transplantation in Hungary

7-year-old boy, who underwent aortic valve replacement two years previously, suffered from idiopathic dilated cardiomyopathy. Because of poor condition (NYHA-IV), heart transplantation was performed on 18th October 2007. It was the first pediatric heart transplantation in Hungary. It was an uneventful early postoperative period, 6 months after the operation he is doing well, no biopsy-proven and tissue Doppler echocardiography (TDI-derived velocities measurement) rejection was detected. The immunosuppression was based on triple-drug therapy (tacrolimus+mycophenolate mofetil+corticosteroid) with use of induction therapy with interleukin-2 receptor blocker (basiliximab).