The influence of immunosuppressive therapy and diabetes mellitus on surgical complications observed in patients after orthotopic heart transplantation

Background: Surgical wounds and bedsores therapy is very important in
treating patients after orthotopic heart transplantation (OHT). Aim: The aim of the study was to assess the infl uence of immunosuppressive therapy and diabetes mellitus on wound healing and bedsore appearing in the very beginning after heart transplantation performed in Silesian Center for
Heart Diseased (SCCS).
Material/Methods: We analysed the early results of 149 consecutive OHT
procedures performed in SCCS between 1.01.2000 and 30.06.2008. In the
primary immunosuppressive protocol tacrolimus was used in 59 pts (group
A; 47M,12F), cyclosporine-A in 90 pts. (group B; 76M, 14F). Special nursing care of surgical wound and bedsore prophylaxis was performed in every patient after OHT according to SCCS care guidelines.
Results: The rate of bedsore appearing was greater in group A, but the rate
of wound complications was greater in group B. Diabetes mellitus was observed more often in patients with incorrect wound healing.
Conclusions: Immunosuppressive therapy, particularly cyclosporine-A, and
diabetes mellitus have signifi cant influence on surgical complications observed in patients after orthotopic heart transplantation.

Keywords: Heart Transplantation