Clinical characteristics of hemodynamics and laboratory parameters of recipients during orthotopic heart transplantation

Objective. To study the clinical and laboratory characteristics of recipients during orthotopic heart transplantation according to intraoperative monitoring. Materials and methods. The clinical and laboratory data of 38 patients who underwent orthotopic heart transplantation for vital indications in the period from 2022 to 2024 were studied. The average age of patients was (38.5 ± 13.5) years. There were 35 men (92.1%) and 3 women (7.9%). Peripheral oxygen saturation, arterial and central venous pressure were measured in each recipient delivered to the operating room at 5 stages of the operation during orthotopic heart transplantation. Results. The main cause of chronic heart failure with subsequent heart transplantation in all 38 (100%) patients was dilated cardiomyopathy. Statistically significant (p < 0.05) acidosis and hypercapnia in recipients during heart transplantation were most pronounced at the first stage of surgery, before the connection of a heart–lung machine. Acidosis during heart transplantation had a mixed metabolic and respiratory genesis with hypercapnia and lactatacidosis. A statistically significant (p < 0.05) increased lactate content at the first and second stages and statistically significant (p < 0.05) hyperglycemia at all stages of surgery were found. Central venous pressure was statistically significantly (p<0.05) higher than the reference values at the stages of sternum cutting and before the connection of the heart–lung machine. A direct statistically significant (p<0.05) correlation between the level of arterial blood pH and the level of central venous pressure (r=0.334) was established, with the corresponding linear regression equation: pH=4.7043+central venous pressure × 0.02391. Conclusions. Clinical and laboratory characteristics of recipients undergoing orthotopic heart transplantation demonstrated a direct correlation between mixed metabolic and respiratory acidosis and central venous pressure. Peripheral hemodynamic parameters in orthotopic heart transplantation were characterized by instability at the stage of heart–lung machine disconnection.