同期心脏和肺移植6例

背景：心肺移植目前仍然是治疗终末期心肺疾病的最好方法,但由于诸多原因国内的供者短缺是一个很严峻的问题。目的：观察利用同一供者对不同受者同期进行心、肺移植的可行性。方法：将3例供者的心脏、肺脏分别同期移植给3例相同血型的终末期心脏疾病受者和3例终末期肺脏疾病受者,观察移植效果。结果与结论：6例患者中有1例双肺移植患者出现右肺上叶静脉栓塞于术后第9天再次手术切除后痊愈,术后30d出院。1例双肺移植患者1个月出现感染经对症治疗后好转,于术后2个月出院。1例心脏移植患者出现早期肾功能衰竭,经血液透析治疗后痊愈出院。余3例患者均安全渡过围手术期后痊愈出院,到目前有3例仍有很好的生活质量。提示利用同一供者的心、肺分别给不同受者进行心、肺移植,能充分利用供者,缩短受者等待时间。

Contemporaneous heart and lung transplantation in 6 cases

BACKGROUND：Heart and lung transplantation remain the optimal treatment for end-stage heart and lung diseases, but donor shortage in China is a very serious problem because of various reasons. OBJECTIVE：To discuss the possibility of heart and lung transplantation for different recipients with same donor’s heart and lung at the same time. METHODS：Hearts and lungs were obtained from 3 donors, transplanted into 3 cases with end-stage heart diseases and 3 cases with lung diseases. Heart and lung transplantation performed separately at the same time. The transplantation outcomes were observed. RESULTS AND CONCLUSION：Among double-lungs transplantation patients, one had developed venous embolism and conducted right pulmonary upper lobectomy at 9 days and discharged at 30 days after operation. Another recipient got infection and cured with antibiotics. One heart transplant patient suffered renal dysfunction and then was treated with consecutive renal replacement therapy. The remains had no postoperative complications. All these recipients got through the postoperative period and had good life quality. Heart and lung transplantation for different recipients with same donor can maximize the use of available donor and save more patients’ lives.