原位心脏移植28例报道

Summary of orthotopic cardiac transplantation in 28 cases

目的总结28例心脏移植的临床资料,探讨手术效果以及免疫诱导方法。方法2000年1月至2005年5月共完成28例同种原位心脏移植术。2003年前进行心脏移植的14例受者围手术期采用环孢素A+霉酚酸酯免疫诱导方案,2003年后的14例受者采用达利珠单抗+霉酚酸酯免疫诱导方案。结果28例受者均顺利完成手术,术后无出血、扭曲、右心功能不全等手术并发症。2003年前移植的受者中,有6例出现不同程度的肝、肾功能不全,3例并发不同程度的感染。2003年后移植的受者无1例术后发生肝、肾功能不全和感染。结论心脏移植是治疗终末期心肌病变的有效手段。达利珠单抗+霉酚酸酯诱导方法效果较好。

Objective To summarize the clinical data of cardiac transplantation in 28 patients of our hospital, and study the effectiveness of operation and the methods of immunosuppressive regime. Methods From January 2000 to May 2005, in our center, 28 patients were subjected to orthotopic cardiac transplantation. In early stage （before 2003） cielosporin A and mycophenolate mofetil were used for immunosuppression. In late stage （after 2003） Daclizumab and myeophenolate mofetil were used for immunosuppression. Results Orthotopic cardiac transplantations were done successfully in 28 patients. There was no haemorrhage, twist and right heart insufficiency postoperatively. In the patients before 2003, the complications of hepatic-renal inadequacy to varying degrees occurred in 6 cases and infection in 3 cases respectively. In the patients after 2003, there were no complications of hepaticrenal inadequacy and infection. Conclusions Cardiac transplantion is an effective way for end stage car diomyopathy. Immunosuppressive effect of Daclizumab and mycophenolate mofetil is satisfactory.