Jessup M, Brozena S C
Temple University Hospital, Philadelphia, Pennsylvania.
Cardiol Clin. 1990 Feb;8(1):11-21.
Transplantation should be performed to improve the quality and duration of life in patients with end-stage cardiac disease. Symptoms, left ventricular ejection fraction, previous and present medications, and an exercise tolerance test serve as basic screening information to identify potential transplant candidates. Patients need to have a psychological, financial, and behavioral profile that will allow them to withstand the rigors of the entire transplantation process, and have no other medical problems that would jeopardize their survival following transplant surgery. Maintenance of the patient's status while awaiting a cardiac donor begins with patient education and a search into the causes of underlying ventricular dysfunction. Medications subsequently used include diuretic agents, vasodilators, digitalis, anticoagulants, antiarrhythmics, and possibly beta-blocker therapy. When standard measures fail, potent inotropes and even mechanical assist devices are sometimes necessary. Future donor heart allocations will require more rigid criteria for the selection of cardiac transplant candidates.
进行心脏移植应旨在改善终末期心脏病患者的生活质量和延长其寿命。症状、左心室射血分数、既往和当前用药情况以及运动耐量测试可作为基本筛查信息，以确定潜在的心脏移植候选者。患者需要具备心理、经济和行为方面的条件，以便能够承受整个移植过程的严酷考验，并且不存在其他会危及移植手术后生存的医疗问题。在等待心脏供体期间维持患者的状态始于患者教育以及对潜在心室功能障碍原因的探究。随后使用的药物包括利尿剂、血管扩张剂、洋地黄、抗凝剂、抗心律失常药，可能还包括β受体阻滞剂治疗。当标准措施无效时，有时需要使用强效强心剂甚至机械辅助装置。未来心脏供体的分配将需要更严格的标准来选择心脏移植候选者。
