Hoercher K, McCarthy P, Young J B
Kaufman Center for Heart Failure, Cleveland Clinic Foundation, Ohio, USA.
Clin Transpl. 1999:239-48.
The past 15 years has seen a significant evolution of heart transplant patient selection criteria, definition of suitable donors, immunosuppressive strategies, infection prophylaxis and treatment, and post-transplant patient surveillance. Primarily important has been broadening of the donor suitability definition and an evolution toward transplanting more ill and hemodynamically unstable patients. Despite "pushing the envelope" with both patient and donor selection and with transplanted patients generally being more ill, we believe our outcomes at the Cleveland Clinic Foundation are exemplary. The one- and 3-year survival rates for 265 heart transplants performed during 1996-1998 were 88% and 81%, respectively. Key to the success of our program has been close interdisciplinary working relationships and respect, broad and expert consultative support services, a desire to investigate clinical challenges, and dedication to excellence. Of additional importance is the realization that no matter how difficult we believe our difficulties are, we realize that those of our patients are vastly greater.
在过去的15年里，心脏移植患者的选择标准、合适供体的定义、免疫抑制策略、感染预防与治疗以及移植后患者监测都发生了显著演变。其中最重要的是供体适用性定义的拓宽，以及朝着为病情更重、血流动力学不稳定的患者进行移植的方向发展。尽管在患者和供体选择方面不断突破界限，且移植患者总体病情更重，但我们认为克利夫兰诊所基金会的治疗结果堪称典范。1996年至1998年期间进行的265例心脏移植手术的1年和3年生存率分别为88%和81%。我们项目成功的关键在于紧密的跨学科合作关系与相互尊重、广泛且专业的咨询支持服务、对临床挑战进行研究的意愿以及追求卓越的奉献精神。同样重要的是，我们意识到无论我们认为自己面临的困难有多大，我们的患者所面临的困难要大得多。
