SEQUENTIAL ORTHOTOPIC HEART TRANSPLANTATION IN MAN
SEQUENTIAL ORTHOTOPIC HEART TRANSPLANTATION IN MAN
复制标题
人类序贯原位心脏移植
DOI：
10.1097/00007890-198012000-00002
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发表时间：
1980
期刊：
影响因子：
6.2
通讯作者：
N. Shumway
中科院分区：
文献类型：
--
作者：
D. Watson;B. Reitz;P. Oyer;E. Stinson;N. Shumway
1968年1月至1980年3月期间，斯坦福大学医学中心已将202颗心脏移植到185名患者体内。偶尔，移植后的患者发生心肌衰竭，只能再次移植。16例患者使用标准技术进行初始原位同种异体移植。8名患者发生加速性动脉粥样硬化性冠状动脉疾病，6名患者发生无情的排斥反应，2名患者发生供体心律失常或右心室衰竭，需要再次移植。1例患者因供体左心室缺血需要第三次移植。所有连续移植的管理与初次移植相似。在有风险的初始移植心脏中，60%存活超过1年，57%存活超过2年。这些结果与不需要再次移植的患者相似。在有风险的二次移植心脏中，31%存活超过1年，29%存活超过2年。感染和/或排斥反应的严重程度对二次心脏移植死亡率的贡献最大。序贯性原位心脏移植为同种异体移植失败的患者提供了一种可接受的替代方案。由于序贯移植中免疫抑制时间延长，存活率不如初次移植。
Between January 1968 and March 1980, 202 hearts had been transplanted into 185 patients at Stanford University Medical Center. Occasionally, patients after transplantation develop myocardial failure which is amenable only to retransplantation. Sixteen patients underwent initial orthotopic allograft using standard techniques. Eight patients developed accelerated arteriosclerotic coronary disease, six had unrelenting rejection, and two had donor heart dysrrhythmia or right ventricular failure requiring retransplantation. One patient required a third transplant because of donor left ventricular ischemia. All sequential transplants were managed similarly to the primary transplant. Of the initial transplant hearts at risk, 60% survived for more than 1 year, and 57% survived for more than 2 years. These results are similar to those of patients not requiring retransplantation. Of the secondary transplant hearts at risk, 31% survived for more than 1 year and 29% survived for more than 2 years. The severity of infection and/or rejection contributed most significantly to secondary heart transplant mortality. Sequential orthotopic cardiac transplantation offers an acceptable alternative to patients with allograft failure. Survival is not as favorable as with initial transplantation because of the prolonged immunosuppression during sequential transplantation.