Kriett J M, Kaye M P
University of California, San Diego 92103-1990.
J Heart Transplant. 1990 Jul-Aug;9(4):323-30.
During the past decade we have witnessed a continuing evolution in intrathoracic transplantation. The role of heart transplantation in end-stage heart disease has been well established; and combined heart-lung and lung transplantation techniques developed during the past 10 years have been applied to an expanding array of diseases associated with end-stage pulmonary failure. Recently a plateau in number of transplants per year has become evident. Although the areas of pediatric heart and single lung transplantation continue to expand, it appears that further overall growth in heart and lung transplantation is now limited by donor availability. Although operative mortality has shown gradual improvement, organ preservation and other intraoperative complications remain major factors associated with early death, especially in combined heart-lung and lung transplantation. Infection and rejection are the most common causes of late deaths for all types of intrathoracic transplantation. Although long-term survival has shown improvement over the past 10 years, an increasing number of patients now require retransplantation because of chronic rejection. Results with heart, combined heart-lung, and lung retransplantation, in operative mortality and in long-term survival, have not been as encouraging as with the primary transplant procedure. We await further developments in heart and lung transplantation during the new decade.
在过去十年中，我们见证了胸内器官移植的不断发展。心脏移植在终末期心脏病中的作用已得到充分确立；过去十年中发展起来的心肺联合移植和肺移植技术已应用于越来越多与终末期肺衰竭相关的疾病。最近，每年移植手术数量已明显趋于平稳。尽管小儿心脏移植和单肺移植领域仍在不断拓展，但心脏和肺移植的进一步总体增长目前似乎受到供体来源的限制。虽然手术死亡率已逐渐降低，但器官保存及其他术中并发症仍是导致早期死亡的主要因素，尤其是在心肺联合移植和肺移植中。感染和排斥反应是所有类型胸内器官移植晚期死亡的最常见原因。尽管过去十年中长期生存率有所提高，但由于慢性排斥反应，现在越来越多的患者需要再次移植。心脏、心肺联合及肺再次移植在手术死亡率和长期生存率方面的结果，并不像初次移植手术那样令人鼓舞。我们期待在新的十年中心脏和肺移植能有进一步的发展。
