8例同种异体原位心脏移植的应用体会

目的:总结8例同种异体原位心脏移植手术的处理经验,探讨心脏移植的围术期处理及预防感染等问题。方法:2004年5月至2006年2月,先后进行了8例同种异体心脏移植手术,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 强的松口服联合抗免疫治疗。结果:8例患者均于术后6周左右康复出院。1例患者术后8个月因严重感染死亡,余7例患者心功能状况及生活质量良好,未出现明显免疫排异反应和肺部感染等并发症。结论:重视心脏移植的围术期处理及感染的预防,可使患者顺利康复,提高生存率和生活质量。

Clinical Experience of Orthotopic Homologous Heart Transplantation

Objective:To review the experience of management for orthotopic homologous heart transplantation in 8 patients, discuss some problems such as perioperative treatment, immunosuppressive therapy and infection prevention. Methods: Orthotopic homologous heart transplantation in 8 patients was performed during May 2004 to February 2006, with the procedure of the bicaval heart transplantation. The combination of cyclosporine mycophenolate mofetil prednisone was given for postoperative immunosuppressive therapy. Results: Eight patients were discharged about 40 days after heart transplantation. During the period of follow-up, 1 patient died of severe infection. The other 7 patients had normal heart function and no rejection reaction or pulmonary infection was found. Conclusion:Proper perioperative management, immunosuppressive therapy, prevention of infection are important factors for smooth recovery. These factors are strongly associated with survival rate following heart transplantation.