Simonsen S, Geiran O, Lindberg H, Foerster A, Hysing E, Mohr B, Forfang K, Ihlen H, Frøysaker T
Medisinsk avdeling B, Rikshospitalet, Oslo.
Tidsskr Nor Laegeforen. 1991 Jan 30;111(3):302-5.
We discuss our experience from 6 1/2 years of orthotopic heart transplantation at Rikshospitalet (the National Hospital). 112 grafts were performed on 109 patients (19 women and 90 men), mean age 47 years (range 14-63). In the first nine patients the immunosuppressive regimen consisted of cyclosporine A and prednisolone, and in the last 100 azathioprine was added (triple medication). There was no operative mortality. 21 patients died, giving an 81% cumulative survival, with a significantly better prognosis among those who received triple immunosuppressive regimen. The main complications were rejection, infection and arrhythmia. Since our main problem was rejection it is concluded that careful supervision, concentrated on as few cardiologists as possible, and a liberal indication for myocardial biopsy, are decisive for the prognosis.
我们讨论了在国家医院里司医院进行6年半原位心脏移植的经验。对109例患者（19名女性和90名男性）进行了112次移植，平均年龄47岁（范围14 - 63岁）。前9例患者的免疫抑制方案由环孢素A和泼尼松组成，后100例添加了硫唑嘌呤（三联用药）。无手术死亡病例。21例患者死亡，累积生存率为81%，接受三联免疫抑制方案的患者预后明显更好。主要并发症为排斥反应、感染和心律失常。由于我们的主要问题是排斥反应，因此得出结论，由尽可能少的心脏病专家进行仔细监测以及放宽心肌活检的指征对预后起决定性作用。
