1035 Gender Equality in Heart Transplantation: A Single Centre Study

Background

International Society for Heart and Lung Transplantation catergoirises female gender in donor/recipient, as a significant risk factor for mortality after heart transplantation. Further, donor-recipient gender mismatch is also reported to be a determinant of post-transplant morbidity/mortality. To examine the effect of gender in survival outcomes, we conducted a retrospective study.

Method

Population comprised of 298 patients undergoing heart transplantation from 2001 to 2021, divided into four groups on the basis of donor and recipient matching. Group A consisted of men who received male donor-hearts, group B of women who received female donor-hearts, group C of women who received male donor-hearts, and group D of men who received female donor-hearts. Standard heart transplantation protocols were applied to all patient groups for graft preservation, surgical technique, donor-recipient size matching, induction & immunosuppressive therapy.

Results

The study groups were found to be homogeneous to the major preoperative- risk- factors (aetiology, transplantation status, donor-recipient-age, total ischemic time). Donor gender, recipient gender and donor-recipient gender mismatching did not significantly modify the short and mid-term survivals, functional recovery, and primary graft dysfunction post-surgery.

Conclusions

Even though previous reports suggest that gender negatively affects survival, this proved to have no influence on the outcomes in our study. These results can be explained by a correct donor-recipient size matching. The well-documented female recipients’ tendency to more frequent and fatal rejection was not confirmed in our experience. The patient's age at transplantation, the routine use of induction therapy and an aggressive immunosuppressive regimen may be the substrate of these findings.

Delayed aorto-right atrial fistula following percutaneous closure of atrial septal defect

We present the case of a 27-year-old man who underwent percutaneous atrial septal defect (ASD) repair using the Amplatzer(®) (St Jude Medical, St Paul, MN, US) septal occluder (ASO). Six weeks later, he presented with heart failure and was found to have an aorto-right atrial fistulation. He required urgent surgical device explantation and repair of the existing ASD using a pericardial patch repair technique. This is the first case to be reported from the UK describing a delayed aorto-right atrial fistula following percutaneous closure using ASO.

[Interobserver concordance in functional assessment by Barthel Index]

BACKGROUND

The aim of this study is to analyze interobserver "reproductiveness" between clinical nurses in gerontology and residents in family medicine in their first contact with the Barthel Index (BI).

MATERIALS AND METHODS

One hundred patients were assessed. BI at two weeks before admission was scored by a patient or carer interview. Eighteen patients were excluded because interviews were not completed.

RESULTS

Mean BI of 82 patient included, assessed by nurses was 87.3 and by residents 88.2. In 40 patients some differences in the mean values of BI were observed. When analyzing the overall BI score the agreement was high (r=0.793) but interobserver agreement was low (kappa<0.4) in some fields such as eating, dressing and transfers and medium in others (kappa from 0.40 to 0.75).

CONCLUSIONS

Low reproductiviness interobserver in some patients of the BI when clinical nurses in gerontology and residents in family medicine are compared suggest that they need specific training in functional capacity evaluation in order to improve the BI use.

[Decrease of catatonic schizophrenia in patients hospitalized in 1984 in comparison to 1964]

It has been suggested that manifestations of mental illnesses have been changing during the last decades. Thus, the catatonic form of schizophrenia is scarcely observed nowadays and should be about to disappear. Changes in both catatonic schizophrenia prevalence, and catatonic symptoms are analyzed according to revisions dated 1964, and 1984, of the clinical records to be found at the Psychiatric Clinic, University of Chile. A diminution of schizophrenia catatonic forms in 1984 records was found out when comparing with 1964 records. A diminution of catatonic symptons--usually associated to severe forms of schizophrenia--was also noticeable. In both groups, however, such variations have no relation whatever with the extent of the evolutive period prior to institutionalization.

The microbiologic flora of orofacial abscesses

Fifty orofacial abscesses were studied using culture techniques for both aerobic and anaerobic organisms. Eighty-six per cent of the specimens contained anaerobes; of this group, 39 per cent had organisms resistant to penicillin.