Goldberg Sara W, Fisher Stacy A, Wehman Brody, Mehra Mandeep R
Division of Pediatric Cardiology, Boston Children's Hospital, Boston, Massachusetts.
Division of Cardiovascular Medicine, University of Maryland School of Medicine, Baltimore, Maryland.
J Heart Lung Transplant. 2014 Sep;33(9):873-7. doi: 10.1016/j.healun.2014.05.001. Epub 2014 Jun 2.
The growing population of adults with congenital heart disease (ACHD) present a distinct set of challenges in the evaluation, listing, and safe performance of heart transplantation. We review existing literature to (1) describe the complex anatomic and physiologic features that characterize this group of patients, (2) discuss factors contributing to high waiting list times and waiting list morbidity and mortality experienced by this population, and finally, (3) identify risk factors for the elevated post-transplant morbidity and mortality reported in ACHD patients. We conclude with a discussion of critical areas in need of further investigation as well as ways to amend the current listing criteria to better accommodate ACHD patients in need of heart transplantation.
先天性心脏病成年患者（ACHD）数量的不断增加，给心脏移植的评估、列入名单以及安全实施带来了一系列独特的挑战。我们回顾现有文献，以（1）描述表征这组患者的复杂解剖和生理特征，（2）讨论导致该人群等待名单时间长以及等待名单上出现发病和死亡情况的因素，最后，（3）确定ACHD患者移植后发病和死亡风险升高的危险因素。我们最后讨论了需要进一步研究的关键领域，以及修改当前列入名单标准以更好地接纳需要心脏移植的ACHD患者的方法。
