同种原位心脏移植26例

Orthotopic heart transplantation of twenty-six cases

目的 :总结 2 6例终末期心脏病患者施行原位心脏移植术的经验。方法 :2 0 0 1年 1月 2 6日至 2 0 0 3年 9月 2 6日 ,先后对 2 6例终末期心脏病患者施行原位心脏移植术。供者均为脑死亡者 ,供心保护采用灌注冷晶体心脏停搏液 ,术式为标准原位心脏移植术 ,术后采用新三联他克莫司 (FK5 0 6)骁悉和泼尼松免疫抑制治疗。结果 :6例死亡 ,2 0例患者存活至今 ,生活质量良好。结论 :选择合适供、受体 ,加强围术期处理及合理免疫抑制治疗是提高心脏移植术后疗效的重要因素。

Objective A review of experience in orthotopic heart transplantation from twenty six cases. Methods From Jan 2000 to sep 2003 twenty six patients with end stage heart disease underwent orthotopic heart transplantation. Donors were all brain death patients. The donor hearts were protected by perfusing cold cardioplegia. The technique of operations were standard orthotopic heart transplantation. The new immunosuppressive triple therapy (tacrolimus + mycopenolatemofetil + prednisone) was taken postoperatively. Results Six patiens died. Twenty patients survived with good quality of life. Conclusions Accurate selection for recipient and donor, correct perioperative management, suitable curing of the acute cardic rejection are important factors for improvement of the curative effect after transplantation.