心脏移植供心的心肌保护研究

Experience of cardiac protection of orthotopic heart allograft transpalantation

目的总结4例心脏移植的供心保护经验。方法缩短热缺血时间,切除供心时先以冷晶停跳液500 ml灌注,使供心迅速停搏,心包内放入冰屑使供心降温,切除供心后,再灌注0-4℃UW保存液1000 ml(6-8分钟灌注完),用浸泡法低温保存供心,4例供心热缺血时间分别为3、4、6、6分钟,冷缺血时间分别为220、415、215、226分钟。结果升主动脉开放后,3例自动复跳,1例电击除颤后复跳,围手术期供心功能良好,术后患者康复顺利,现心功能均为Ⅰ级。结论用此方法可使供心得到良好的心肌保护。

Object To analyze the experience of cardiac protection of orthotopic heart allograft transpalantation in four cases. Methods The donor hearts were flushed with St. Thomas solution 500 ml for arrest, meantime,ice was placed in the pericardium. After harvested, the donor heart was minsed in 1000 ml 0℃ -4℃ UW solution for storage. The warm ischemic time of three donor hearts was 3 min, 4 min, 6 min, 6 min respectively,and the cold ischemic time was 220 min, 415 min, 215 min , 226 min. respectively. Results After declaping of the aorta, three of the hearts were recover sinus rhythm automatically, one of which was defibrillated. The perioperative cardiac function of the patients were excerlent and discharged successfully. Now the cardiac function of the four patients were class Ⅰ Conclusion Our method of cardiac protection can provide, good cardiac function preservation