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Biomedical subjects

C Van Meter

Publications and source records attributed to C Van Meter.

10 recordsLinked to original sources
PubMed1998

Cardiac transplantation.

Cardiac transplantation has proven to be an effective and life-saving option for those patients with congestive heart failure who deteriorate despite maximal medical management. The recipients have been able to return to life as productive citizens with improved quality as well as quantity of life. Advances in assist-device technology will mean that more patients will survive until donor hearts become available and ultimately may supplement the organ supply by serving as an alternative to transplant in some patients.

Heart Failure↗
PubMed1995

The risks, benefits, and costs of expanding donor criteria. A collaborative prospective three-year study.

The study purpose was to identify risks, benefits and costs associated with an expanded donor protocol. The protocol design evaluated organs rescued using expanded donor criteria and weighed all costs associated with doing so. Costs were measured against conditions experienced with expanded and traditional criteria and recipient outcome. Traditional donors were between 5 and 55, with negative serologies, and no history of hypertension or diabetes. "Expanded donors" were between 55 and 75 or less than 5, with a history of hypertension, diabetes and/or sero-positive for Hepatitis C. During this study 73 donors met criteria from which 200 organs were transplanted. Defined costs and outcomes for recipients were tracked. Using expanded criteria: costs averaged 20% more per organ; OPO personnel spent an average of 6 hours more time on-site; an additional 12-14 hours in placement activity; and average organs per donor decreased. Heart patient and graft survival rates for traditional and expanded donor organs were comparable. Kidney patients transplanted from this pool experienced a decrease in patient (P = .14) and a significant decrease in graft (P = .02) survival rates. Patient (P = .05) and graft (P = .01) survival rates were significantly lower in liver patients transplanted with expanded donor organs. Two hundred transplants occurred using expanded donor criteria. Costs for the OPO increased appreciably. Heart and kidney utilization from these donors seems justified. It is thought that liver recipients' results were due to utilizing them in sicker patients. Recovery of organs from donors using expanded criteria appears to be a reasonable way of increasing organ supply.

Adolescent↗
PubMed1994

Cardiac transplantation after donor mitral valve commissurotomy.

Cardiac transplantation has become a relatively common procedure, with its limiting factor being the lack of donor hearts. The donor pool can potentially be increased by reevaluating donor criteria and performing innovative procedures on the donor heart, such as coronary bypass and valve repair. We present a recent case of donor heart mitral valve commissurotomy with successful transplantation.

Heart Transplantation↗
PubMed1993

Induction immunosuppression with the monoclonal antibody OKT3 after cardiac transplantation.

The routine use of monoclonal induction immunosuppression with OKT3 after orthotopic heart transplantation remains controversial. This study examined the clinical response of prophylactic monoclonal induction immunosuppression versus standard triple-drug immunosuppression in 41 patients who underwent orthotopic heart transplantation from January 1989 to December 1990 at this institution. Of these, eight received monoclonal induction immunosuppression for a period of 10 to 14 days. All patients received identical triple-drug immunosuppression with the exception of cyclosporine starting on the fifth postoperative day in those who received OKT3. At 6 months the duration of hospitalization, freedom from rejection, incidence of infection requiring hospitalization, and serum creatinine in the monoclonal induction immunosuppression and triple-drug groups were compared. It was found that the length of hospital stay in the OKT3 group was 14.3 +/- 4.5 days, compared with 14.7 +/- 4.7 days in the triple-drug group and that freedom from rejection was 66% in the OKT3 group compared with 75% in the triple-drug group. In addition, it was found that the incidence of infection was 36% in the OKT3 group compared with 38% in the triple-drug group and that serum creatinine at 6 months was 1.36 +/- 0.26 mg/dl in the OKT3 group compared with 1.45 +/- 0.73 mg/dl in the triple-drug group. Finally, patient survival at 1 year for the monoclonal induction immunosuppression group was 100% compared with 91% for the triple-drug group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenal Cortex Hormones↗
PubMed1990

Partial anomalous pulmonary venous return.

Anomalous pulmonary venous return from the left lung is an extremely rare condition that is reported sporadically and in general in case reports. From 1964 through 1988, we identified 13 patients with this condition, all of whom underwent surgical correction. This represents the single largest reported institutional experience with this anomaly. The patients ranged in age from 15 months to 40 years. Seven were asymptomatic, and six had symptoms ranging from recurrent pulmonary infection to moderate congestive heart failure. Six had anomalous venous return from the entire left lung, and seven had anomalous return from the upper lobe only. Eight of the patients had associated cardiovascular anomalies. Four of the patients underwent surgical correction via a sternotomy approach with cardiopulmonary bypass to allow correction of coexisting intracardiac anomalies. The remaining patients underwent surgical repair through a left thoracotomy. The technique included high ligation and division of a persistent left superior vena cava with anastomosis to the left atrium at the site of partial excision of the atrial appendage. There were no deaths and only one complication in our series.

Anastomosis, Surgical↗
PubMed1985

Acute renal failure in the cardiovascular surgical patient.

Acute renal failure is a known complication of cardiovascular surgery and is associated with a high mortality. Therapy should be aimed at prevention of oliguric renal failure, or at least its conversion to nonoliguric renal failure. Once renal failure is established, early dialysis with nutritional support probably gives the best chance for survival.

Acute Kidney Injury↗
PubMed1980

Abortive H-tracheal esophageal malformation.

This communication describes a bizarre esophageal anomaly (abortive H-tracheoesophageal malformation) in a 4-yr-old boy. Our review of the literature failed to uncover an exact duplicate of the surgical findings in this case, which were corrected by an end-to-end anastomosis.

Child, Preschool↗
PubMedDate not supplied

Chylopericardium after orthotopic heart transplantation.

Chylopericardium is an infrequent cause of pericardial effusions after heart surgery and to our knowledge has not been reported after orthotopic transplantation. We report the occurrence of chylopericardium in a heart transplant recipient who was successfully treated with a pericardial window, pericardiocentesis, and a diet rich in medium-chain triglycerides.

Chyle↗