CLINICAL HEART AND HEART-LUNG TRANSPLANTATION

该计划的总体目标仍然是评估和验证 临床心脏移植作为治疗程序。 具体 该计划中纳入的科学目标是针对 技术的发展和完善，以最大限度地提高术后生存率。 这些措施包括：1）细化临床标准，以选择潜在的 最有可能在手术后实现康复的心脏受者，以及 评估临床、生理和心理社会因素的影响 术前对受者生存和康复的影响; 2）相关性 组织相容性分型和受体免疫反应性， 术后排斥反应史和生存率; 3）技术定义 用于术后评估宿主免疫反应、诊断和预测 通过直接组织学评估对急性移植物排斥反应进行分级， 经静脉肌内膜活检，以及与 用兔抗人抗胸腺细胞球蛋白治疗与发作时间， 术后移植物排斥反应的频率和严重程度; 4）识别和 管理与移植相关的心理和社会压力; 和5）功能和电生理特性的定义， 移植的人心脏，对各种药理学和生理学的反应， 干预，以及生理和病理解剖学变化的评价 与术后晚期并发症如移植物动脉硬化有关。 此外，临床心脏移植计划构成了一个 全国心脏移植示范项目 国际层面。 此外，它还为医务人员提供深入培训， 和外科实习生在临床和研究方面的这种形式， 器官移植

The general goal of this program remains the evaluation and validation of clinical cardiac transplantation as a therapeutic procedure. The specific scientific objectives incorporated in the program are directed toward development and refinement of techniques to maximize post-operative survival. They include: 1) refinement of clinical criteria for the selection of potential cardiac recipients most likely to achieve rehabilitation after operation, and assessment of the impact of clinical, physiological, and psychosocial factors present preoperatively on recipient survival and rehabilitation; 2) correlation of histocompatibility typing and recipient immunological responsiveness with postoperative rejection history and survival; 3) the definition of techniques for postoperative assessment of host immune responses, diagnosis and predictive grading of acute graft rejection by direct histological assessment with transvenous endomyocardial biopsy, and correlation of kinetic data relating to treatment with rabbit antihuman antithymocyte globulin with time of onset, frequency and severity of post-operative graft rejection; 4) identification and management of psychological and social stresses associated with transplantation; and 5) definition of functional and electrophysiological properties of the transplanted human heart, responses to various pharmacological and physiological interventions, and evaluation of the physiological and pathoanatomical changes associated with late postoperative complications such as graft arteriosclerosis. In addition, the clinic heart transplantation program constitutes a demonstration project in heart transplantation on both national and international levels. It furthermore provides in-depth training to both medical and surgical trainees in clinical and investigational aspects of this form of organ transplantation.