13例原位心脏移植围术期的处理

Management of cardiac transplantation during perioperative periocl

目的总结原位心脏移植围手术期的治疗方法。方法13例扩张性心肌患者进行了同种原位心脏移植，围手术期间加强受体的维护、供心离体时间的保护、血流动力学的支持、抗排异反应及感染方面的处理。结果11例患者存活，2例死亡。结论选择合适的供体和受体、良好的供心保护技术、有效的血流动力学支持、抗排异反应方疗案得当、防止感染是围手术期处理的重要组成部分，是手术成功的关键。

Objective To sum up the methods of perioperative management of orthotopic cardiac transplantation. Methods 13 recipients snfered from terminal myocardiosis. The transplantive operation was performed with inferior and superior vena anastomotic technique.During perioperative period ,we selected and maintained the recipients, protected donor isolated heart, supported circulation, decreased immunitive reaction, controlled infections. Results 11 patients survived and 2 patients died. Condusion Suitable recipient and donor heart procurement and preservation, suitable maintenance of circulation, proper managements of anti-immunitive reaetionand prevention of infections are critical for successful heart transplatation.