同种异体原位心脏移植术体外循环特点(附1例报告)

目的探讨心脏移植术体外循环心肌保护、血液成分保护及预防排斥反应，体外循环技巧等问题。方法对体外循 环下同种异体原位心脏移植患者的临床资料进行分析。结果采用标准法该例患者进行原位心脏移植，供心热缺血时间 为０ｍｉｎ，冷缺血时间为７０ｍｉｎ，总体外循环时间为１２３ｍｉｎ，升主动脉阻断时间７３ｍｉｎ。患者已存活２５０ｄ。术后患者无 排斥反应、感染、心及肝肾功能不全等并发症。结论良好的心肌保护、血液成分保护、体外循环过程预防排斥反应及完 善的体外循环操作技巧是心脏移植成功的关键。

Features of cardiopulmorary bypass in orthotopic homologous heart transplanlation: report of 1case

Objective: To study the myocardial protection, blood protection, prevention of allograft rejection and the technique for cardipulmonary bypass(CPB) in heart transplantation. Methods The clinical data from 1 case of orthotopic homologous heart transplantation were reviewed. Results The recipient was a 43-year-old female patient with end-stage expansionary cardiomyopathy. The operation was performed by standard technique. The hot ischemic time of the dornor was 0 min and cold ischemic time 70 min. The total CPB time was 123 min and the period of aortic crossclamp time 73 min. The patient has survived for 250 d after the operation. There were no heart allograft rejection or severe complications postoperatively. Conclusion The success of heart transplantation depends on the good myocardial and blood protection, prevention of rejection and skillful implementation of CPB techniques.