同种异体原位心脏移植的临床应用(附1例报告)

Application of orthotopic heart allograft transplantation

目的 总结分析 1例同种异体原位心脏移植术的临床经验。方法 采用双腔静脉吻合法对终末期扩张性心肌病病人进行同种异体原位心脏移植术。患者术前曾两次出现心跳骤停 ,经心肺复苏成功。供体为脑死亡者 ,供心采用 4°C改良St Thomas保护液。术后免疫抑制治疗采用环孢素A、骁悉、强的松三联治疗 ,根据血环孢素浓度及超声心动图调整环孢素A用量。结果 患者顺利渡过围手术期 ,心功能恢复正常 ,出院至今生活质量良好。结论 术后合理监测与抗排异治疗 ,积极、正确处理并发症可提高生存率和生存质量。

Objective To analyze the experience of orthotopic heart allograft transplantation in one case.Methods Orthotopic heart allograft transplantation was performed on a patient with terminal dilated cardiomyopathy by using bicaval anastoma.Cardiac arrest happened to the patient twice,and she was saved after resuscitation.The donor was brain death and the donor heart was preserved in cold St.Thomas solution at 4°C .After operation,immunosupressive therapy was applied including cyclosporine A+ MMF+prednisone.And the cyclosporine was adjusted according to blood concentration.Results The patient passed the perioperation period successfully with cardiac function recovering to be normal.And she kept good life quality after discharge.Conclusion Survival rate and life quality can be improved through appropriate supervision,anti-rejection treatment and properly solving the complications in time.