Laske A, Carrel T, Pasic M, Bauer E, Niederhäuser U, von Segesser L K, Turina M
Departement Chirurgie, Universitätsspital Zürich.
Helv Chir Acta. 1992 Aug;59(2):377-82.
The orthotopic heart transplantation is an accepted treatment for terminal cardiac disease. The technique of heart procurement and preservation is explained and the primary graft function in 108 subsequent heart transplantations is assessed. The mean ischemia time is 41 +/- 10 min in local, 98 +/- 19 min in distant (< 100 km) and 114 +/- 16 min in distant (> 100 km) organ procurement. Our method of preservation consists of cold cardioplegic arrest with potassium (30 mEq/L) cardioplegic solution. The incidence of the indication for high dose katecholamine-treatment after surgery and the maximal creatininekinase levels rose with ischemia time. All hearts recovered within a few days and the stay in the intensive care unit was not prolonged. We conclude that the heart preservation with cold cardioplegic arrest results in a good primary graft function. It is important to keep the ischemia time as short as possible.
原位心脏移植是终末期心脏病公认的治疗方法。本文阐述了心脏获取与保存技术，并评估了随后108例心脏移植中的原发性移植物功能。在局部器官获取中，平均缺血时间为41±10分钟，在距离较近（<100公里）的器官获取中为98±19分钟，在距离较远（>100公里）的器官获取中为114±16分钟。我们的保存方法包括用含钾（30 mEq/L）心脏停搏液进行冷心脏停搏。术后高剂量儿茶酚胺治疗指征的发生率和肌酐激酶最高水平随缺血时间增加而上升。所有心脏在数天内恢复，重症监护病房停留时间未延长。我们得出结论，冷心脏停搏保存心脏可带来良好的原发性移植物功能。尽可能缩短缺血时间很重要。
