Stuart A G, Wren C, Sharples P M, Hunter S, Hey E N
Department of Paediatric Cardiology, Freeman Hospital, Newcastle upon Tyne, UK.
Lancet. 1991 Apr 20;337(8747):957-9. doi: 10.1016/0140-6736(91)91581-e.
Neonatal cardiac transplantation offers the prospect of survival for babies with hypoplastic left heart syndrome--but only if suitable donors are available. In a retrospective survey in the Northern health region of England and Wales, the likely need for neonatal cardiac transplantation far outweighed the potential availability of donors. Over 8 years (1983-90) hypoplastic left heart syndrome was identified in 38 newborn babies and in 9 fetuses in utero. Of 41 live births (including 3 diagnosed prenatally) 31 would have been candidates for a cardiac transplant, but only 4 suitable donors could be identified (3 with anencephaly born alive during the same period and 1 who died between 1979 and 1986 after a head injury). Analysis of all infant deaths in 1987-89 revealed only 3 potential donors from 426 deaths in the 3 years. Although more widespread antenatal diagnosis may lead to fewer liveborn babies with hypoplastic left heart syndrome, these findings indicate that an alternative source of donors needs to be identified before neonatal cardiac transplantation can be widely used in the treatment of this disorder.
新生儿心脏移植为患有左心发育不全综合征的婴儿带来了生存的希望——但前提是要有合适的供体。在对英格兰和威尔士北部卫生区域进行的一项回顾性调查中，新生儿心脏移植的潜在需求远远超过了供体的潜在可获得性。在8年期间（1983 - 1990年），在38名新生儿和9名子宫内胎儿中确诊为左心发育不全综合征。在41例活产儿（包括3例产前诊断）中，有31例本可成为心脏移植的候选者，但仅确定了4名合适的供体（3例同期出生的无脑儿活产儿以及1例在1979年至1986年间因头部受伤死亡者）。对1987 - 1989年所有婴儿死亡情况的分析显示，在这3年的426例死亡中仅有3名潜在供体。尽管更广泛的产前诊断可能会减少左心发育不全综合征的活产儿数量，但这些发现表明，在新生儿心脏移植能够广泛用于治疗这种疾病之前，需要确定其他供体来源。
