Abstract
Heart transplantation has become widespread in world practice lately. Literary data examining algorithms for managing pa- tients after a heart transplant that require surgical intervention is not enough. We have described a clinical case of successful removal of a big benign tumor of the ovary by laparoscopic approach in a patient after a heart transplant. It was shown that laparoscopy seems to be technically feasible, therapeutically safe method with a short period of rehabilitation after the intervention, low risk of infectious and postoperative complications. The use of Fluxum® may be an acceptable alternative to the use of other low molecular weight heparins for the prevention of venous thromboembolic complications in patients at high risk of thrombosis. However, when planning an operation, consideration should be given to the possibility of develop- ing complications that threaten the function of the transplant and the life of the patient, and to closely monitor patients in the perioperative period.
REFERENCES
1. Nishimura R. A., Otto C. M., Bonow R. O. et al. American College of Cardiology/American Heart Association Task Force on Prac- tice Guidelines. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;63(22): e57–e185.
2. Singh I., Patel B. N., Thohan V., Hemal A. K. Robot-assisted lap- aroscopic radical prostatectomy after heart transplantation. Urol Ann. 2013;5(1):56–8.
3. Statistics of the Russian Transplant Society (RTO) for 2017. [Statis- tika Rossijskogo transplantologicheskogo obshchestva (RTO) za 2017 god]. Vestnik transplantologii i iskusstvennyh organov. 2018;20(2):10–12 (in Russ.).
4. Heart transplantation. National clinical guidelines. [Transplant- aciya serdca. Nacional’nye klinicheskie rekomendacii]. Moskva, 2013. 93 s (in Russ.). URL: www.transpl.ru/images/cms/data/ pdf/nacional_nye_klinicheskie_rekomendacii_po_transplanta- cii_serdca.pdf. [Accessed: 31.01.2019].
5. Lane B. R., Aron M., Pritchard C. et al. Laparoscopic cystoprosta- tectomy in a heart transplant recipient. Surg Laparosc Endosc Per- cutan Tech. 2008;18(3):319–21.
6. Savar A., Hiatt J. R., Busuttil R. W. Acute appendicitis after solid organ transplantation. Clin Transplant. 2006;20(1):78–80.
7. Takeyama H., Sinanan M. N., Fishbein D. P. et al. Expectant man- agement is safe for cholelithiasis after heart transplant. J Heart Lung Transplant. 2006;25(5):539–43.
8. Gynecology. National guidelines. [Ginekologiya. Nacional’noe rukovodstvo (Pod red. V.I. Kulakova, G.M. Savel’evoj, I.B. Manuhina)]. Moskva: GEOTAR-Media, 2009. 520 s (in Russ.).
9. Khoraki J., Katz M. G., Funk L. M. et al. Feasibility and outcomes of laparoscopic sleeve gastrectomy after solid organ transplanta- tion. Surg Obes Relat Dis. 2016;12(1):75–83.
10. Kilic A., Sheer A., Shah A. S. et al. Outcomes of cholecystectomy in US heart transplant recipients. Ann Surg. 2013;258(2):312–7.
11. De’Angelis N., Esposito F., Memeo R. et al. Emergency abdomi- nal surgery after solid organ transplantation: a systematic review. World J Emerg Surg. 2016;11(1):43.
12. Spartalis M., Spartalis E., Tzatzaki E. et al. Cardiac allograft vascu- lopathy after heart transplantation: current prevention and treat- ment strategies. Eur Rev Med Pharmacol Sci. 2019;23(1):303–11.
13. Sokologorsky S. V. Anesthetic tactics in pregnant women with a transplanted heart. [Anesteziologicheskaya taktika u beremen- nyh s peresazhennym serdcem]. 2015. 28 s (in Russ.). URL: www. arfpoint.ru/wpcontent/uploads/2015/04/1610_Sokologorskij_ Beremennost-i-rodi-u-Jenshin-posle-Transplantatsii-serdtsa.pdf. [Accessed: 31.01.2019].
14. Guideline for anticoagulation and prophylaxis using low molec- ular weight heparin (LMWN) in adult inpatients. Oueensland Government Department of Health. Document Number # QH- GDL-951. 2015. 15 p. URL: www.health.qld.gov.au/__data/assets/ pdf_file/0023/147533/qh-gdl-951.pdf. [Accessed: 31.01.2019].
15. Morozov K. M., Kolbin A. S., Galankin T. L. Network meta-analy- sis for parnaparin effectiveness in venous thromboembolism pre- vention in surgery. [Setevoj meta-analiz effektivnosti primeneniya parnaparina dlya profilaktiki venoznyh tromboembolicheskih os- lozhnenij pri hirurgicheskih vmeshatel’stvah]. Tromboz, gemostaz i reologiya. 2018;(1):31–9 (in Russ.).
16. Camporese G., Bernardi E., Noventa F. Update on the clinical use of the low-molecular-weight heparin, parnaparin. Vasc Health Risk Manag. 2009;5:819–31.
17. Lim C. S., Mowers E. L., Mahnert N. et al. Risk factors and out- comes for conversion to laparotomy of laparoscopic hysterectomy in benign gynecology. Obstet Gynecol. 2016;128(6):1295–305.
18. Elbiss H. M., Abu-Zidan F.M. Bowel injury following gynecologi- cal laparoscopic surgery. Afr Health Sci. 2017;17(4):1237–45. DOI: 10.4314/ahs.v17i4.35.
19. Weitz J. I. Drug therapy: low-molecular-weight heparins. N Engl J Med. 1997;337(10):688–99.
