Autopsy-determined causes of death following cardiac transplantation. A study of 81 patients and literature review.
Autopsy-determined causes of death following cardiac transplantation. A study of 81 patients and literature review.
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尸检确定心脏移植后的死亡原因。
DOI：
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发表时间：
1992
影响因子：
4.6
通讯作者：
Odell Ja
中科院分区：
文献类型：
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作者：
Rose Ag;L. Viviers;Odell Ja
对在南非开普敦Groote Schuur医院死亡的81例心脏移植尸检患者的主要死因和致死因素进行了调查，并根据使用的免疫抑制方案和术后生存期进行了细分。移植物平均存活时间为488天。慢性排斥反应(30%)、感染(23%)和急性排斥反应(20%)是最常见的主要死亡原因。致命性和非致命性感染主要累及肺部。对文献的回顾显示，其他198名尸检的心脏移植患者的主要死因可以被分析；感染占后者死亡的近一半，其次是急性和慢性排斥反应。81例患者的死亡原因依次为：感染(17%)、急性排斥反应(16%)、慢性排斥反应(14%)、其他疾病(14%)、栓塞(14%)、胰腺炎(11%)、消化性溃疡(9%)、供心功能不全(3%)和恶性肿瘤(1%)。我们的结论是，感染以及急性和/或慢性排斥反应仍然是心脏移植患者死亡的主要原因。
The principal and contributory causes of death in 81 autopsied heart transplant patients who died at Groote Schuur Hospital, Cape Town, South Africa, were investigated and subdivided according to the immunosuppressive regimen used as well as the postoperative survival period. Mean graft survival was 488 days. Chronic rejection (30%), infection (23%), and acute rejection (20%) were the most common principal causes of death. Both fatal and nonfatal infections involved the lung predominantly. A review of the literature revealed 198 other autopsied heart transplant patients whose principal cause of death could be analyzed; infection accounted for almost half of these latter deaths, followed by acute and chronic rejection. Contributory causes of death in the 81 patients were as follows: infection (17%), acute rejection (16%), chronic rejection (14%), miscellaneous conditions (14%), embolism (14%), pancreatitis (11%), peptic ulcer (9%), inadequate donor heart (3%), and malignancy (1%). We conclude that infection, together with acute and/or chronic rejection, are still the major causes of death in heart transplant patients.