Cardiac transplantation.

Cardiac transplantation has emerged as an acceptable treatment for patients with end-stage cardiac disease. As a result, it is important for the critical care nurse to understand the principles associated with this procedure and to anticipate complications for this population. This article has reviewed the historical evolution of cardiac transplantation, identified recipient and donor selection criteria, and described the operative technique. Principles of immunosuppression are addressed as compulsory knowledge for the nurse caring for these patients and common immunosuppression agents are delineated. Complications of the early postoperative period are those most commonly encountered by the critical care nurse and include acute cardiac failure, hemorrhage, ECG abnormalities, rejection, infection, and acute renal failure. Frequently occurring nursing diagnoses are listed for cardiac transplant patients during the critical care phase and a care plan is demonstrated. Recognition and treatment of complications in the intensive care unit and the development of a plan of care for the patient by the critical care nurse are crucial to the success of cardiac transplantation.