Subramani Sudhakar, Aldrich Aric, Dwarakanath Sanjay, Sugawara Ami, Hanada Satoshi
University of Iowa, Iowa City, IA, USA.
University of Kentucky, Lexington, KY, USA.
Semin Cardiothorac Vasc Anesth. 2020 Mar;24(1):24-33. doi: 10.1177/1089253219867694. Epub 2019 Aug 5.
Heart transplant can be considered as the "gold standard" treatment for end-stage heart failure, with nearly 5.7 million adults in the United States carrying a diagnosis of heart failure. According to the International Society for Heart and Lung Transplantation registry, nearly 3300 orthotopic heart transplants were performed in 2016 in North America. In spite of significant improvements in overall perioperative care of heart transplant recipients for the past few decades, the risk of 30-day mortality remains 5% to 10%, primarily related to early failure of the allograft. Early graft dysfunction (EGD) occurs within 24 hours after transplant, manifesting as left ventricular dysfunction, right ventricular dysfunction, or biventricular dysfunction. EGD is further classified into primary and secondary graft dysfunction. This review focus on describing overall incidences of EGD, potential risk factors associated with EGD, perioperative preventive measures, and various management options.
心脏移植可被视为终末期心力衰竭的“金标准”治疗方法，美国有近570万成年人被诊断为心力衰竭。根据国际心肺移植协会登记处的数据，2016年北美进行了近3300例原位心脏移植。尽管在过去几十年中心脏移植受者的整体围手术期护理有了显著改善，但30天死亡率风险仍为5%至10%，主要与同种异体移植物早期衰竭有关。早期移植物功能障碍（EGD）发生在移植后24小时内，表现为左心室功能障碍、右心室功能障碍或双心室功能障碍。EGD进一步分为原发性和继发性移植物功能障碍。本综述着重描述EGD的总体发生率、与EGD相关的潜在危险因素、围手术期预防措施以及各种管理选择。
