{"id":17912,"date":"2020-03-25T09:00:00","date_gmt":"2020-03-25T08:00:00","guid":{"rendered":"https:\/\/www.mgc.es\/?p=17912"},"modified":"2020-03-25T10:01:29","modified_gmt":"2020-03-25T09:01:29","slug":"el-trasplantament-de-cor","status":"publish","type":"post","link":"https:\/\/www.mgc.es\/ca\/blog\/el-trasplantament-de-cor\/","title":{"rendered":"El trasplantament de cor"},"content":{"rendered":"\n
\"Trasplante<\/figure>\n\n\n\n

Problemes cardiovasculars greus poden derivar en una malaltia terminal del m\u00fascul card\u00edac i requerir un trasplantament de cor. Qu\u00e8 saps sobre aquest tractament m\u00e8dic? <\/p>\n\n\n\n\n\n\n\n

En qu\u00e8 consisteix un trasplantament de cor?<\/h3>\n\n\n\n

M\u00e8dicament, un trasplantament consisteix en la substituci\u00f3 d’un \u00f2rgan o un teixit malalt per un altre en condicions \u00f2ptimes. En el trasplantament de cor se substitueix un m\u00fascul card\u00edac amb malaltia terminal per un altre cor sa d’una persona que ha mort. Perqu\u00e8 sigui viable, el donant ha d’estar en una mort cerebral que inclogui abs\u00e8ncia de respiraci\u00f3 espont\u00e0nia, per\u00f2 ha de mantenir les funcions b\u00e0siques connectat a un respirador.<\/p>\n\n\n\n

Quan \u00e9s necessari un trasplantament de cor?<\/h3>\n\n\n\n

Quan el pacient presenta un o diversos problemes cardiovasculars que danyen el m\u00fascul card\u00edac i es produeix una insufici\u00e8ncia card\u00edaca terminal.<\/p>\n\n\n\n

El problema cardiovascular m\u00e9s com\u00fa que sol requerir un trasplantament \u00e9s la miocardiopatia dilatada o isqu\u00e8mica<\/strong>. En aquest cas el miocardi est\u00e0 molt debilitat, amb les cavitats dilatades i la funci\u00f3 del ventricle esquerre limitada. A mesura que la malaltia card\u00edaca es va agreujant, el cor es va tornant m\u00e9s feble i no es contrau de la forma adequada, de manera que va perdent la seva capacitat de bombar sang a l’organisme. Per seguir complint la seva funci\u00f3 ho intenta suplir amb un sobreesfor\u00e7 que en va augmentant la mida (hipertr\u00f2fia), per\u00f2 amb el temps el cor es debilita tant que ja no pot complir les seves funcions b\u00e0siques.<\/p>\n\n\n\n

Una altra de les situacions que pot causar un dany irreversible del cor \u00e9s la cardiomiopatia idiop\u00e0tica<\/strong>, que \u00e9s una malaltia del m\u00fascul card\u00edac d’origen desconegut. I en menor mesura, algunes cardiopaties cong\u00e8nites<\/strong>.<\/p>\n\n\n\n

Quan hi ha una mala qualitat de vida, sense expectatives de millora, i no es respon a la medicaci\u00f3 o al tractament quir\u00fargic, l’\u00fanica opci\u00f3 que queda \u00e9s el trasplantament.<\/p>\n\n\n\n

Com es realitza l’avaluaci\u00f3 dels pacients candidats per a un trasplantament card\u00edac?<\/h3>\n\n\n\n

Els millors resultats en la realitzaci\u00f3 d’un trasplantament s’aconsegueixen en pacients menors de 60 anys que no tinguin altres problemes greus de salut a part dels de cor<\/strong>, encara que a partir dels 55 anys s’han de valorar les circumst\u00e0ncies m\u00e8diques de forma individualitzada.<\/p>\n\n\n\n

Els candidats indicats s\u00f3n els pacients que no presentin quadres d’una malaltia hep\u00e0tica avan\u00e7ada (ja que augmenta el risc de mort abans i despr\u00e9s del trasplantament), de malaltia renal cr\u00f2nica (els medicaments immunosupressors que es necessiten despr\u00e9s del trasplantament s\u00f3n t\u00f2xics per al rony\u00f3), de malaltia pulmonar avan\u00e7ada o amb complicacions associades a la diabetis.<\/p>\n\n\n\n

A l’hora d’entrar en llista d’espera per aconseguir un trasplantament s’han de valorar aspectes com el grup sanguini i la mida del cor, que han de ser compatibles amb el donant, aix\u00ed com la salut i les expectatives de vida del pacient. Segons vagin variant aquests factors es poden produir canvis en l’ordre de la llista.<\/p>\n\n\n\n

\"Trasplante<\/figure>\n\n\n\n

Quins riscos hem de tenir en compte despr\u00e9s d’un trasplantament?<\/h3>\n\n\n\n

Encara que la majoria dels trasplantaments de cor solen tenir \u00e8xit, hi ha casos en els quals poden sorgir complicacions. Un d’ells \u00e9s que el cor implantat no funcioni. \u00c9s el que s’anomena “error d’empelt<\/strong>” i se sol detectar ja al quir\u00f2fan mateix o molt poc despr\u00e9s de la intervenci\u00f3.<\/p>\n\n\n\n

Una altra de les causes principals sol ser un rebuig agut del teixit<\/strong>. En aquest cas, el sistema immunitari identifica el cor donat com un teixit ali\u00e8 i tracta de destruir-lo tal com faria amb un virus. Per evitar-ho, s’han d’administrar medicaments immunosupressors que disminueixen la resposta defensiva del sistema immunitarie. Aquesta situaci\u00f3 pot donar-se de forma m\u00e9s freq\u00fcent en els primers mesos i es detecta \u00fanicament realitzant bi\u00f2psies del teixit card\u00edac.<\/p>\n\n\n\n

I \u00e9s precisament l’efecte dels medicaments immunosupressors el que pot augmentar el risc d’infeccions<\/strong> (que \u00e9s la principal causa de mort despr\u00e9s d’un trasplantament de cor), sobretot en els 3 primers mesos. Tamb\u00e9 poden produir un augment en el risc de desenvolupar un c\u00e0ncer, hipertensi\u00f3 arterial, insufici\u00e8ncia renal o insufici\u00e8ncia hep\u00e0tica. Cal aconseguir un equilibri \u00f2ptim en l’administraci\u00f3 d’aquests medicaments.<\/p>\n\n\n\n

Quines taxes de superviv\u00e8ncia t\u00e9 un trasplantament de cor?<\/h3>\n\n\n\n

Actualment hi ha uns nivells de superviv\u00e8ncia superiors al 70% despr\u00e9s dels primers 5 anys i del 50% despr\u00e9s de 10 anys<\/strong>. Amb les cures adequades i una supervisi\u00f3 m\u00e8dica regular, els pacients trasplantats de cor poden veure augmentades les seves expectatives i qualitat de vida, i poden gaudir-ne de forma plena i productiva.<\/p>\n","protected":false},"excerpt":{"rendered":"

Problemes cardiovasculars greus poden derivar en una malaltia terminal del m\u00fascul card\u00edac i requerir un trasplantament de cor. Qu\u00e8 saps sobre aquest tractament m\u00e8dic?<\/p>\n","protected":false},"author":3,"featured_media":17908,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[993,15],"tags":[400,496,611],"class_list":["post-17912","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-cardiologia","category-salut","tag-cardiologia-ca","tag-salut-cardiovascular","tag-transplantament"],"featured_image_src":"https:\/\/www.mgc.es\/wp-content\/uploads\/2020\/03\/trasplante-corazon.jpg","author_info":{"display_name":"Revista Inter\u00e8s Mutu","author_link":"https:\/\/www.mgc.es\/ca\/blog\/author\/interesmutu\/"},"yoast_head":"\nEl trasplantament de cor - MGC M\u00fatua<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.mgc.es\/ca\/blog\/el-trasplantament-de-cor\/\" \/>\n<meta property=\"og:locale\" content=\"ca_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"El trasplantament de cor - MGC M\u00fatua\" \/>\n<meta property=\"og:description\" content=\"Problemes cardiovasculars greus poden derivar en una malaltia terminal del m\u00fascul card\u00edac i requerir un trasplantament de cor. 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