110例原位心脏移植临床经验

目的 总结110例原位心脏移植治疗终末期心脏病患者临床经验及治疗效果.方法 回顾性分析山东省千佛山医院心脏外科(山东省心脏移植中心)2003年3月至2020年7月完成的110例原位心脏移植供者及受者资料,从围手术期处理、免疫抑制的维持、感染监测、术后并发症的治疗以及随访指导等方面进行总结.结果 手术成功率94.5％,术...

Clinical experience of 110 cases of orthotopic heart transplantation

Objective To summarize the clinical experience of orthotopic heart transplantation in 110 cases. Methods Clinical data of 110 cases of heart transplantation in Shandong Provincial Heart Transplantation Center during the past 17 years were retrospectively reviewed. The perioperative management, maintenance of immunosuppression, infection monitoring, management of postoperative complications and follow-up guidance were summarized. Results The success rate of operation was 94.5%. The main postoperative complications were right heart insufficiency(8.18%), organ failure(15.76%), acute rejection(10.91%), lung infection(42.31%)and diabetes(8.18%). Different treatment methods were used and satisfactory results were achieved. During the median postoperative follow-up of 37(1-208)months, the 1-year, 3-year and 5-year survival rates were 95.5%, 84.2% and 70.3%, respectively, and 9 cases survived for more than 10 years. Conclusion Heart transplantation is the most effective treatment for end-stage heart diseases. The key is the success of surgery. Before surgery, we evaluated donor and recipient conditions, matched recipient quality, and tested liver and kidney functions. After surgery, we timely individualized anti-rejection treatment and monitored drug concentration, especially used drug therapy, ventilator, mechanical circulation, continuous renal replacement and plasma exchange, and achieved satisfactory short-term and long-term results.