Retransplantation for severe accelerated coronary artery disease in heart transplant recipients.
Retransplantation for severe accelerated coronary artery disease in heart transplant recipients.
复制标题
心脏移植受者严重加速冠状动脉疾病的再移植。
DOI：
10.1016/0002-9149(88)90885-5
复制
发表时间：
1988
期刊：
影响因子：
--
通讯作者：
Stinson,EB
中科院分区：
文献类型：
--
作者：
Gao,SZ;Schroeder,JS;Hunt,S;Stinson,EB
同种异体心脏移植物中冠脉加速病变（CAD）的发展是心脏移植受者晚期移植物衰竭的主要原因之一。在斯坦福大学医学中心，到1985年1月底，329名患者接受了356例心脏移植手术。这些患者中有89例出现移植性CAD的证据。89例患者中有19例因移植性CAD进行了20例再移植手术，包括2例第三次移植。第二次移植后1年、2年和5年的存活率分别为55%、25%和10%。这些再移植患者中有9人目前存活，最长的存活了5.5年。为了检查发生严重移植性CAD的潜在危险因素，将这20例再移植手术与113例年度冠状动脉造影无移植性CAD证据的移植受者进行比较。移植后CAD再移植组出现过多的排斥反应（3±2次vs 2±1次/例，p = 0.02），总胆固醇升高（266±78 vs 225±47 mg/dl, p = 0.002），低密度脂蛋白水平升高（176±88 vs 137±46 mg/dl, p = 0.009）。11例存活10年的再移植受者中有5例再次发生移植性CAD。二次移植物的形态特征和快速进展与初次移植物相似。综上所述：(1)晚期移植性冠心病患者再移植可以成功，但二次移植后冠心病复发的发生率较高；(2)排斥反应次数、总胆固醇和低密度脂蛋白水平升高可能是发生移植性冠心病的危险因素。
Development of accelerated coronary artery disease (CAD) in the cardiac allograft is one of the major causes of late graft failure in heart transplant recipients. At the Stanford University Medical Center 356 heart transplant procedures were performed in 329 patients by the end of January 1985. Eighty-nine of these patients developed evidence of transplant CAD. Twenty retransplant procedures, including 2 third transplants, were performed in 19 of the 89 patients because of transplant CAD. The graft survival rates after the second transplant were 55%, 25% and 10% after 1,2 and 5 years, respectively. Nine of these retransplant patients currently survive, the longest for 5.5 years. To examine potential risk factors for development of severe transplant CAD, these 20 retransplant procedures were compared with 113 transplant recipients who had no evidence of transplant CAD on annual coronary arteriograms. An excess of rejection episodes (3 ± 2 vs 2 ± 1 episodes/patient, p = 0.02), elevated total cholesterol (266 ± 78 vs 225 ± 47 mg/dl, p = 0.002) and higher low-density lipoprotein levels (176 ± 88 vs 137 ± 46 mg/dl, p = 0.009) were noted in the transplant CAD retransplant group. Five of 11 retransplant recipients who survived >1 year again developed transplant CAD. Characteristic morphologic features and rapid progression of CAD in the second graft were similar to those in the primary graft. In conclusion: (1) retransplantation for the patient with advanced transplant CAD can be successful, but the incidence of recurrent CAD in the second graft is high; and (2) total number of rejection episodes and elevated total cholesterol and low-density lipoprotein levels may be risk factors for the development of transplant CAD.
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影响因子：
3.3
作者：
BUSCH, GJ;GALVANEK, EG;REYNOLDS, ES
通讯作者：
REYNOLDS, ES
心脏移植中加速动脉粥样硬化：细胞毒性 B 细胞抗体和高脂血症的作用。
影响因子：
37.8
作者：
Hess,ML;Hastillo,A;Mohanakumar,T;Cowley,MJ;Vetrovac,G;Szentpetery,S;Wolfgang,TC;Lower,RR
通讯作者：
Lower,RR
Au-SH 抗原和淋巴细胞转化
DOI：
10.1016/s0140-6736(73)92697-4
发表时间：
1973
期刊：
The Lancet
影响因子：
--
作者：
P. Malacarne;B. Dallapiccola
通讯作者：
B. Dallapiccola
影响因子：
6.2
作者：
D. Watson;B. Reitz;P. Oyer;E. Stinson;N. Shumway
通讯作者：
N. Shumway
第11章-移植心脏的疾病
DOI：
10.1016/b978-0-7236-0641-3.50016-5
发表时间：
1983
期刊：
The Thoracic and Cardiovascular Surgeon
影响因子：
--
作者：
M. Billingham
通讯作者：
M. Billingham