Bailey L L, Assaad A N, Trimm R F, Nehlsen-Cannarella S L, Kanakriyeh M S, Haas G S, Jacobson J G
Department of Surgery, Loma Linda University Medical Center, CA 92354-0200.
Ann Surg. 1988 Sep;208(3):279-86. doi: 10.1097/00000658-198809000-00004.
Since November 1985, 14 neonates and young infants have undergone orthotopic heart transplantation at Loma Linda University Medical Center (LLUMC) as therapy for hypoplastic aortic tract complex. Eleven (78%) survived surgery and are living and well today. Three perioperative deaths resulted: one due to perforated peptic ulcer, one due to necrotizing pneumonitis, and one due to graft failure unrelated to rejection. No late deaths occurred in the 1-29 months of follow-up, during which time noninvasive surveillance techniques were used. Immunosuppression was accomplished using cyclosporine and azathioprine. Steroids and antithymocyte globulin were used for identified rejection episodes only. Ordinary childhood infections were tolerated well. All survivors were normotensive. There was no late renal dysfunction. Although inadequate donor resources remain a significant limiting factor for transplantation therapy during early life, these results suggest that cardiac transplantation is effective therapy for selected neonates and young infants with incurable congenital heart disease.
自1985年11月以来，14例新生儿和婴幼儿在洛马林达大学医学中心（LLUMC）接受了原位心脏移植，作为治疗主动脉缩窄复合体发育不全的方法。11例（78%）存活至手术成功，如今生活良好。围手术期有3例死亡：1例死于消化性溃疡穿孔，1例死于坏死性肺炎，1例死于与排斥反应无关的移植物衰竭。在1至29个月的随访期间，采用无创监测技术，未发生晚期死亡。免疫抑制采用环孢素和硫唑嘌呤。仅在确诊排斥反应时使用类固醇和抗胸腺细胞球蛋白。普通儿童感染耐受性良好。所有存活者血压正常。无晚期肾功能不全。尽管供体资源不足仍是早期生命期移植治疗的一个重要限制因素，但这些结果表明，心脏移植对于选定的患有无法治愈的先天性心脏病的新生儿和婴幼儿是一种有效的治疗方法。
