Department of Medicine, Columbia University Medical Center, New York, New York, USA.
J Heart Lung Transplant. 2009 Oct;28(10):1072-4. doi: 10.1016/j.healun.2009.06.004.
Cardiac retransplantation is the definitive treatment for allograft failure despite decreased long-term survival in these patients. The cause of the poorer outcomes in cardiac retransplant patients is unclear.
This study was a retrospective analysis of 859 adult cardiac transplant patients. Of these, 45 (5.7%) underwent cardiac retransplantation at 8.2 +/- 5.3 (mean +/- SD) years after the first transplant, primarily for severe transplant vasculopathy (n = 42).
One-year survival for retransplant patients was significantly lower compared with de novo transplant patients (75% vs 87%; p < 0.003). Twenty-three patients died due to either malignancy (n = 8), infection (n = 6), rejection (n = 3), sudden death (n = 2), recurrent transplant coronary artery disease (n = 2) or post-operative bleeding (n = 1).
Although cardiac retransplantation has immediate life-saving benefits, survival is lower compared with de novo cardiac transplantation due to higher rates of malignancy and infection.
尽管心脏再移植患者的长期存活率降低，但心脏再移植仍是治疗同种异体移植失败的最终手段。导致心脏再移植患者预后较差的原因尚不清楚。
本研究回顾性分析了 859 例成年心脏移植患者。其中 45 例（5.7%）在首次移植后 8.2±5.3（均值±标准差）年接受了心脏再移植，主要是因为严重的移植血管病（n=42）。
与初次移植患者相比，再移植患者的 1 年生存率显著降低（75%比 87%；p<0.003）。23 例患者因恶性肿瘤（n=8）、感染（n=6）、排斥反应（n=3）、猝死（n=2）、复发性移植性冠状动脉疾病（n=2）或术后出血（n=1）而死亡。
尽管心脏再移植具有即时挽救生命的益处，但由于恶性肿瘤和感染的发生率较高，其生存率低于初次心脏移植。
