同种异体原位心脏移植1例报告

Report of a Successful Case of Orthotopic Heart Transplantation

摘要：１９９５年８月２１日为１例终末期扩张型心肌病患者施行原位心脏移植术。术后采用环孢素Ａ、强的松及硫唑嘌呤三联免疫抑制剂治疗方案。术后第２周及第１６周发生急性排异反应，均予以及时治疗。术后１００天出院，至今存活，并恢复了正常生活。认为供心保护良好、手术方法得当、术后无急性右心功能不全、及时治疗急性排异反应等因素是本例术后恢复顺利的关键。

Objective:Orthotopic heart transplantation was successfully performed on one patient with end-stage dilated cardiomyopathy on August 21,1995.Objective and Results:The triple drug immunosuppressive therapy(Cyclosporine,Prednisolone,Azathioprine,)was used postoperatively.In the second week and sixteenth week after operation,two episodes of acute rejection occured and were promptly treated well.Now he has survived for more than six months and is living well.The pre-and post-operative heart function have improved from grade IV to grade I(NYHA).Some important problems such as myocardiac protection of the donor heart,operative skill,prevention of pulmonary hypertension and acute right heart failure at the early postoperative stage,prompt diagnosis and treatment of acute cardiac rejection are discussed in this article,Conclusion:That good myocardiac protection,proper operative skill,without acute right heart failure postoperatively and prompt treatment of the acute rejection were important factors for the smooth recovery.