Hsich Eileen M
From the Heart and Vascular Institute at the Cleveland Clinic, OH; and Case Western Reserve University School of Medicine, Cleveland, OH.
Circ Heart Fail. 2016 Apr;9(4):e002679. doi: 10.1161/CIRCHEARTFAILURE.115.002679.
Heart transplantation is the most effective therapy for patients with Stage D heart failure with a median life expectancy of ≈10 to 15 years. Unfortunately, many patients die on the waiting list hoping for a chance of survival. The life boat cannot rescue everyone. Over a decade, the donor pool has remained relatively stable, whereas the number of heart transplant candidates has risen. Potential recipients often have many comorbidities and are older because the criteria for heart transplantation has few absolute contraindications. Women, Hispanics, and patients with restrictive heart disease and congenital heart disease are more likely to die while awaiting heart transplantation than men, white patients, and those with either ischemic or dilated cardiomyopathy. To better match the market, we need to (1) increase the donor pool, (2) reduce the waitlist, and (3) improve the allocation system. This review article addresses all 3 options and compares strategies in the United States to those in other countries.
心脏移植是治疗D期心力衰竭患者最有效的方法，患者中位预期寿命约为10至15年。不幸的是，许多患者在等待获得生存机会的名单上死亡。救生船无法拯救所有人。十多年来，供体库一直相对稳定，而心脏移植候选者的数量却有所增加。潜在受者通常有许多合并症且年龄较大，因为心脏移植的标准几乎没有绝对禁忌证。与男性、白人患者以及患有缺血性或扩张型心肌病的患者相比，女性、西班牙裔以及患有限制性心脏病和先天性心脏病的患者在等待心脏移植期间更有可能死亡。为了更好地匹配市场，我们需要：（1）增加供体库；（2）减少等待名单；（3）改进分配系统。这篇综述文章探讨了所有这三个选项，并将美国的策略与其他国家的策略进行了比较。
