Durdu Serkan, Akar Rüçhan, Cavolli Raif, Eren Neyyir Tuncay, Corapçioğlu Tümer, Uçanok Kemalettin, Ozyurda Umit
Department of Cardiovascular Surgery, Ankara University School of Medicine, Ankara, Turkey.
Anadolu Kardiyol Derg. 2003 Sep;3(3):252-60.
Cardiac transplantation has emerged as the therapeutic procedure of choice for patients with end-stage heart disease but the availability of donor organs remains major limiting factor allowing only 1% of the candidates actually become transplant recipients. New therapeutic strategies are under intensive research for patients who do not meet patient selection criteria for transplantation or who suffer from donor organ shortage. Even though there are significant developments in the medical treatment of cardiac failure, the prognosis of this condition continues to be poor. The 20-40% of the candidates for cardiac transplantation die while they are included in the waiting list. Twenty percent mortality has been reported within the first year of transplantation with additional yearly mortality of 5% following the first year. Financial constraints, complications of immunosuppression and functional failure of the transplanted hearts are other limiting factors. This has brought up the necessity to search for alternative surgical treatment methods besides increasing the waiting periods of transplant candidates. The aim of this report is to summarize other currently available therapeutic alternatives for patients with end-stage cardiac disease.
心脏移植已成为终末期心脏病患者的首选治疗方法，但供体器官的可用性仍然是主要限制因素，只有1%的候选者能够真正成为移植受者。对于不符合移植患者选择标准或供体器官短缺的患者，新的治疗策略正在深入研究中。尽管心力衰竭的药物治疗有了重大进展，但这种疾病的预后仍然很差。20%至40%的心脏移植候选者在等待名单上时死亡。据报道，移植后第一年的死亡率为20%，第一年之后每年还有5%的额外死亡率。经济限制、免疫抑制并发症和移植心脏的功能衰竭是其他限制因素。这就使得除了延长移植候选者的等待时间外，还必须寻找其他替代手术治疗方法。本报告的目的是总结目前终末期心脏病患者可用的其他治疗选择。
