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Feature Article

Heart transplantation: care of recipients

Ning Song, Kavitha Muthiah

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© AFRICA STUDIO/SHUTTERSTOCK
© AFRICA STUDIO/SHUTTERSTOCK

Abstract

GPs do not commonly see patients who have undergone heart transplantation, although the number of recipients each year is increasing. Prompt contact with the transplant centre for specialised review by the heart transplant team is recommended in the event of a patient exhibiting early signs of complications.

Key Points

  • Care for heart transplant recipients encompasses a wide range of complex medical problems and requires the primary treating clinician to be highly vigilant of the possible complications that may arise, including infection, malignancy, hypertension and diabetes.
  • A patient with allograft rejection may exhibit symptoms such as dyspnoea and palpitations and present with signs of fluid retention. At times they may be asymptomatic or present with nonspecific symptoms such as fatigue. A screening echocardiogram is appropriate until an endomyocardial biopsy can be performed in a transplant centre.
  • To prevent rejection, monitoring of trough calcineurin inhibitor and proliferation signalling inhibitor levels, which may be affected by some foods and medications, is important. Long-term adjustment of levels is best performed in transplant centres during regular review.
  • Prompt contact with the transplant centre for specialised review by the heart transplant team is recommended in the event of a patient exhibiting early signs of complications.

Figures

© AFRICA STUDIO/SHUTTERSTOCK
© AFRICA STUDIO/SHUTTERSTOCK