Lala Anuradha, Joyce Emer, Groarke John D, Mehra Mandeep R
Brigham and Women's Hospital Heart and Vascular Center and Harvard Medical School.
Circ J. 2014;78(2):288-99. doi: 10.1253/circj.cj-13-1498. Epub 2014 Jan 21.
The burden of advanced heart failure is reaching epidemic proportions. Generally considered for cardiac transplantation, patients often cannot receive this therapy because of their advanced age, comorbidity or the scarcity of donors. Most transplants are concentrated in North America and Europe, with the average center performing fewer than 20 annual transplants. A search for nonbiological means of cardiac support has led to the advent of mechanical circulatory support (MCS), a concept now entrenched as a bridge to transplantation or, for those ineligible for transplantation, as lifetime therapy. In this review we discuss contemporary challenges posed by the changing epidemiology of cardiac transplant and MCS and outline the basis for an understanding of the future of this important therapeutic stance.
晚期心力衰竭的负担正呈流行趋势。这类患者通常被考虑进行心脏移植，但由于年龄较大、合并其他疾病或供体稀缺，往往无法接受这种治疗。大多数心脏移植集中在北美和欧洲，平均每个中心每年进行的移植手术不到20例。对心脏支持的非生物手段的探索导致了机械循环支持（MCS）的出现，这一概念现在已确立为移植的桥梁，或者对于那些不符合移植条件的患者来说，作为终身治疗手段。在本综述中，我们讨论了心脏移植和MCS流行病学变化带来的当代挑战，并概述了理解这一重要治疗立场未来发展的基础。
