Pflugfelder P W, Singh N R, McKenzie F N, Menkis A H, Novick R J, Kostuk W J
Department of Medicine (Division of Cardiology), University of Western Ontario, University Hospital, London, Canada.
J Heart Lung Transplant. 1991 May-Jun;10(3):394-400.
Of 219 heart transplant patients with follow up for at least 3 months after transplantation, cardiac allograft ischemic time was more than 4 hours in 28% and more than 5 hours in 10%. In 1988 and 1989 grafts with ischemic times longer than 4 hours were used in 44% and 45% of cases, respectively. Overall, donor age has been 35 or more years in 22% and 45 or more in 9%. In 1989 donor age was 35 or more years in 39% of cases and 45 or more in 18%. Fifteen of 20 grafts from donors 45 years or older were used for patients aged 50 or older. There was no relationship between donor age or ischemic time and 90-day graft loss. At 3 and 12 months, cardiac function, assessed by treadmill exercise duration, radionuclide angiography, and rest and peak supine exercise hemodynamics, was also unrelated to donor age or ischemic time. Therefore by careful selection of appropriate donors, extending both graft ischemic time and donor age has increased the potential donor pool and has not to date been associated with increased graft loss or adverse effects on cardiac function 3 months and 1 year after heart transplantation.
在219例心脏移植患者中，移植后至少随访3个月，心脏同种异体移植物缺血时间超过4小时的占28%，超过5小时的占10%。在1988年和1989年，缺血时间超过4小时的移植物分别在44%和45%的病例中使用。总体而言，供体年龄35岁及以上的占22%，45岁及以上的占9%。1989年，供体年龄35岁及以上的病例占39%，45岁及以上的占18%。20例来自45岁及以上供体的移植物中有15例用于50岁及以上的患者。供体年龄或缺血时间与90天移植物丢失之间没有关系。在3个月和12个月时，通过跑步机运动持续时间、放射性核素血管造影以及静息和仰卧位运动峰值血流动力学评估的心脏功能，也与供体年龄或缺血时间无关。因此，通过仔细选择合适的供体，延长移植物缺血时间和供体年龄都增加了潜在供体库，并且迄今为止，与心脏移植后3个月和1年时移植物丢失增加或对心脏功能的不良影响无关。
