Guglin Maya
Mechanical Assisted Circulation Program, University of Kentucky, Lexington, KY, USA,
Heart Fail Rev. 2015 Jan;20(1):95-105. doi: 10.1007/s10741-014-9434-y.
Cardiac transplantation is the best treatment available for patients with end-stage cardiomyopathy. Shortage of donor hearts is the main factor limiting the use of this treatment. Many donor hearts are rejected for transplantation because of left ventricular (LV) systolic dysfunction and/or wall motion abnormalities. While some donors have true cardiomyopathy, a significant proportion has reversible LV dysfunction due to neurogenic stunned myocardium. This condition is triggered by excess of catecholamines, which is typical for brain-dead donors. If given time to recover, LV function may improve, and the heart will be suitable for transplantation. Moreover, limiting of exogenous catecholamines may facilitate the recovery. In this review, we summarize the data on LV dysfunction/wall motion abnormalities in heart donors and propose the strategy to increase the utilization of donor hearts.
心脏移植是终末期心肌病患者可采用的最佳治疗方法。供体心脏短缺是限制这种治疗方法应用的主要因素。许多供体心脏因左心室（LV）收缩功能障碍和/或室壁运动异常而被拒绝用于移植。虽然一些供体患有真正的心肌病，但相当一部分人因神经源性心肌顿抑而出现可逆性左心室功能障碍。这种情况是由儿茶酚胺过量引发的，这在脑死亡供体中很常见。如果给予恢复时间，左心室功能可能会改善，心脏将适合移植。此外，限制外源性儿茶酚胺可能有助于恢复。在本综述中，我们总结了心脏供体左心室功能障碍/室壁运动异常的数据，并提出了提高供体心脏利用率的策略。
