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4 results on '"H. Pisarska"'

1. Comparison of Surgical Wound Infection Etiology in Patients Treated with Short-Term Pulsatile Mechanical Circulatory Support, Receiving Heart Transplant, or Undergoing Other Cardiac Surgery Procedure

Author

Jerzy Pacholewicz, A. Larysz, H. Gancarczyk, Izabela Copik, Michał Zembala, H. Pisarska, M. Siola, B. Urbanczyk, and Michał Zakliczyński

Subjects
Pulmonary and Respiratory Medicine, Heart transplantation, Transplantation, medicine.medical_specialty, biology, business.industry, medicine.medical_treatment, Skin flora, Pulsatile flow, Surgical wound, biology.organism_classification, Surgery, Cardiac surgery, Circulatory system, Etiology, Medicine, In patient, Cardiology and Cardiovascular Medicine, business
Abstract

Purpose Treatment using of short-term pulsatile mechanical circulatory support (MSC) is often realized in units that are common for all patients undergoing cardiac surgery (CS), including orthotopic heart transplantation (OHT). Aim of the study was to compare the etiology of surgical wound infection among patients receiving MCS treatment, OHT, or standard CS procedure. Methods and Materials A retrospective analysis of wound infections was performed in 8998 patients undergoing CS in years 2007-2012: 5 patients treated with MCS (23M/2F, 41.2±15y/o, 21LVAD/4BIVAD), 195 OHT recipients (128M/67F, 44.4±17y/o), and 8778 patients undergoing remaining CS procedures (6116M/2662F, 62.0±12y/o). A comparison of wound infection frequency as well as specific pathogens occurrence among MSC, OHT and CS patients was performed for the whole period of observation and for each year separately. Results Superficial wound infections were found in 6(24%) MCS patients, 8(4.1%) OHT recipients, and 97(1.1%) CS patients (p Conclusions Despite localization in the same hospital unit MCS and other CS patients don’t share the same etiology of wound infections. Gram-negative flora is predominant in MCS patients, while typical Gram-positive skin flora is more frequent source of infection in OHT and CS patients.

Published
2013
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3. Diagnosis and treatment of steroid resistant cellular rejection in heart transplant recipients--single center experience.

Author

Zakliczyński M, Nozyński J, Zakliczyńska H, Kozłowska K, Trzcińska I, Szewczyk M, Konecka-Mrówka D, Foremny J, Swierad M, Przybylski R, Pisarska H, Wojarski J, Durmała J, and Zembala M

Subjects
Adolescent, Adult, Antilymphocyte Serum adverse effects, Antilymphocyte Serum therapeutic use, Case-Control Studies, Drug Resistance, Female, Graft Rejection epidemiology, Graft Rejection etiology, Graft Rejection physiopathology, Hemodynamics drug effects, Humans, Immunosuppressive Agents therapeutic use, Incidence, Infections etiology, Male, Middle Aged, Mortality, Mycophenolic Acid therapeutic use, Risk Factors, Survival Analysis, T-Lymphocytes immunology, Graft Rejection diagnosis, Graft Rejection therapy, Heart Transplantation, Mycophenolic Acid analogs & derivatives, Steroids therapeutic use
Abstract

Objectives: Aim of the study was to assess frequency and risk factors of steroid resistant cellular rejection (SRR) in heart transplant recipients, to determine methods of its treatment, and to evaluate influence of steroid resistant rejection and method of its treatment on short- and long-term results., Methods: All pts. received cyclosporine-A, azathioprine and prednisone. Biopsy results > or = 3A (ISHLT) were considered a significant rejection, requiring treatment with 1 g i.v. methylprednizolone for 3 days followed by oral prednisone. SRR was recognized in case of biopsy-proven progression of rejection, lack of improvement in 2 consecutive biopsies, or increasing hemodynamic compromise despite treatment of biopsy-proven rejection. 146 pts. eligible for the study were divided into: study group--15 pts. with SRR (10%), and control group--131 pts. SRR was treated with: cytolytic therapy--ATG (10 pts.), mycophenolate mofetil (3 pts.) or steroids (2 pts.). Number of biopsies > or = 3A, cumulative biopsy score, average biopsy result, effectiveness of SRR treatment, side effects of therapy, and survival were analysed., Results: All parameters characterizing rejection were significantly higher in the study group. No risk factors of SRR were found. In 6 pts. with SRR and hemodynamic compromise (all treated with ATG) improvement was observed in 4 pts, while death occurred in 2 pts. There were no deaths in pts. without hemodynamic compromise--none of 3 methods of treatment was superior, however ATG increased the infection risk. Survival in the 1st year was significantly lower in the study group (67% vs. 89% in the control group)., Conclusions: SRR is recognized in about 10% of heart transplant recipients, increasing risk of death in the 1st year after surgery. Cytolytic therapy increases risk of infection, and should be avoided in pts. without hemodynamic compromise.

Published
2003

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