Aortic valve replacement for patient with infective endocarditis early after liver transplantation with a complete withdrawal of immunosuppressive therapy
https://doi.org/10.23873/2074-0506-2017-9-4-306-311
Abstract
The number of patients with severe liver failure awaiting transplantation is increasing steadily. The shortage of donor organs, in turn, leads to long waiting time for liver transplants and increases the likelihood of decompensation and progression of the disease, significantly increasing the proportion of urgent patients on the waiting list for liver transplantation. This article presents a clinical case report of a successful multistage surgical and therapeutic treatment of complications in a patient before and after liver transplantation. In the early postoperative period, the recipient of the liver from a deceased donor underwent the debridement of the aortic root and the aortic valve replacement for the treatment of acute infective endocarditis, with the immunosuppressive therapy being discontinued for 3 weeks without a deterioration of the graft function.
About the Authors
S. F. Bagnenko
First Saint-Petersburg State Medical University n.a. acad. I.P. Pavlov
Russian Federation
Russian Federation
Acad. of RAS, Prof., Rector of the First Saint-Petersburg State Medical University n.a. Acad. I.P. Pavlov
St. Petersburg
N. N. Shikhverdiev
Military Medical Academy n.a. S.M. Kirov;
Saint-Petersburg Research Institute of Emergency Medicine n.a. I.I. Dzhanelidze
Russian Federation
St. Petersburg
Russian Federation
St. Petersburg
O. N. Reznik
First Saint-Petersburg State Medical University n.a. acad. I.P. Pavlov;
Saint-Petersburg Research Institute of Emergency Medicine n.a. I.I. Dzhanelidze
Russian Federation
St. Petersburg
Russian Federation
St. Petersburg
A. N. Anan'ev
First Saint-Petersburg State Medical University n.a. acad. I.P. Pavlov
Russian Federation
St. Petersburg
Russian Federation
St. Petersburg
A. E. Skvortsov
First Saint-Petersburg State Medical University n.a. acad. I.P. Pavlov
Russian Federation
St. Petersburg
Russian Federation
St. Petersburg
V. S. Dayneko
Saint-Petersburg Research Institute of Emergency Medicine n.a. I.I. Dzhanelidze
Russian Federation
St. Petersburg
Russian Federation
St. Petersburg
I. V. Ul'ankina
Saint-Petersburg Research Institute of Emergency Medicine n.a. I.I. Dzhanelidze
Russian Federation
St. Petersburg
Russian Federation
St. Petersburg
D. V. Gogolev
First Saint-Petersburg State Medical University n.a. acad. I.P. Pavlov
Russian Federation
St. Petersburg
Russian Federation
St. Petersburg
A. R. Bigashev
Saint-Petersburg Research Institute of Emergency Medicine n.a. I.I. Dzhanelidze
Russian Federation
St. Petersburg
Russian Federation
St. Petersburg
D. O. Kuz'min
Saint-Petersburg Research Institute of Emergency Medicine n.a. I.I. Dzhanelidze
Russian Federation
St. Petersburg
Russian Federation
St. Petersburg
S. Y. Falevko
Saint-Petersburg Research Institute of Emergency Medicine n.a. I.I. Dzhanelidze
Russian Federation
St. Petersburg
Russian Federation
St. Petersburg
References
1. Aranzana E.M., Coppini A.Z., Ribeiro M.A., et al. Model for End-Stage Liver Disease, Model for Liver Transplantation Survival and Donor Risk Index as predictive models of survival after liver transplantation in 1,006 patients. Clinics (Sao Paulo). 2015;70(6):413–418. PMID:26106959 DOI:10.6061/clinics/2015(06)05
2. Cárdenas A., Ginès P. Management of patients with cirrhosis awaiting liver transplantation. Gut. 2011;60(3):412–421. PMID:21193458 DOI:10.1136/gut.2009.179937
3. Wagener M.M., Yu V.L. Bacteremia in transplant recipients: a prospective study of demographics, etiologic agents, risk factors, and outcomes. Am J Infect Control. 1992;20(5):239–247. PMID:1443756
4. Borde D.P., Gandhe U., Hargave N., Pandey K. Perioperative management of emergency aortic valve replacement for infective endocarditis after liver transplantation. Ann Card Anaesth. 2013;16(3):227–279. PMID:23816685 DOI:10.4103/0971-9784.114248
5. Paterson D.L., Dominguez E.A., Chang F.Y., et al. Infective endocarditis in solid organ transplant recipients. Clin Infect Dis. 1998;26(3):689–694. PMID:9524846
6. George S., Varghese J., Chandrasekhar S., et al. Gram-negative bacteria causing infective endocarditis: Rare cardiac complication after liver transplantation. World J Hepatol. 2013;5(5):296–297. PMID:23717742 DOI:10.4254/wjh.v5.i5.296
7. Hearn C.J., Smedira N.G. Pulmonic valve endocarditis after orthotopic liver transplantation. Liver Transpl Surg. 1999;5(5):456–457. PMID:10477849 DOI:10.1002/lt.500050509
8. Davari H.R., Malek-Hosseini S.A., Salahi H., et al. Liver transplantation and aortic valve replacement. Int J Organ Transplant Med. 2011;2(1):32–36. PMID:25013592
9. Pocar M., Passolunghi D., Moneta A., Donatelli F. Primary and redo valve replacement before and after liver transplantation. Eur J Cardiothorac Surg. 2007;32(4):674–675. PMID:17692529 DOI:10.1016/j.ejcts.2007.07.006
10. Flecher E., Joudinaud T., Tahta S., Duran C. Cardiac surgery after liver transplantation. Ann Cardiol Angeiol (Paris). 2005;54(3):141–143. PMID:15991470 DOI:10.1016/j.ancard.2005.04.008
Review
For citations:
Bagnenko S.F., Shikhverdiev N.N., Reznik O.N., Anan'ev A.N., Skvortsov A.E., Dayneko V.S., Ul'ankina I.V., Gogolev D.V., Bigashev A.R., Kuz'min D.O., Falevko S.Y. Aortic valve replacement for patient with infective endocarditis early after liver transplantation with a complete withdrawal of immunosuppressive therapy. Transplantologiya. The Russian Journal of Transplantation. 2017;9(4):306-311. (In Russ.) https://doi.org/10.23873/2074-0506-2017-9-4-306-311
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