同种异体原位心脏移植10例应用体会

Clinical experience of orthotopic homologous heart transplantation

10例终末期心脏病患者进行同种异体心脏移植手术,均为男性,其中8例为扩张型心肌病,1例为限制型心肌病,1例为心脏恶性肿瘤。手术方法全部采用双腔静脉法行原位心脏移植。术后均采用环孢素A+骁悉+泼尼松口服联合抗免疫治疗。结果显示术后9例存活,手术成功率为90%(9/10)。随访2～94个月,其中有1例失随访,4例患者死亡。余5例生活全部自理,恢复正常的生活,最长存活患者术后存活期已超过7年,存活患者术后死亡的主要原因包括急性排斥反应和感染。

10 patients, all males, diagnosed as having dilated cardiomyopathy in 8, restrictive cardiomyopathy in 1, primary malignant cardiac tumor in 1 at the Center of Cardiac Surgery. All the operative procedures were bicaval anastomosis cardiac transplantation. The combination of cyclosporine ＋ mycophenolate mofetil ＋ prednisone was ap- plied as the postoperative immunosuppressive therapy. The success rate of the surgery was 90% （9/10）. One of the patients was failed for follow-up. Other 4 patients died, one of them died of infection in the early postoperation. The other 5 patients all had ability to care for themselves, and gradually returned to normal life. One of them has lived for more than seven years after surgery, a longest survival time postoperation. Acute rejection and infections were the main causes of death.