Li Fei, Wang Yixuan, Sun Yongfeng, Zhang Jing, Li Ping, Dong Nianguo
Department of Cardiovascular Surgery, Wuhan Union Hospital, Huazhong University of Science and Technology, Wuhan 430022, China.
Ann Transl Med. 2020 Apr;8(7):467. doi: 10.21037/atm.2020.03.99.
To perform a retrospective analysis of 47 cases of pediatric heart transplantation in a single Chinese center.
The study included 47 cases of heart transplantation under 18 years old, completed between Sep 1, 2008 and Dec 31, 2018. We carried out statistical analysis of the clinical features of the donors and recipients, perioperative information, postoperative complications and short- and mid-term survival.
The study included 24 males and 23 females. The average age on transplantation was 10.34±4.80 years (minimum 3 months, median 11.00 years). Preoperative diagnosis included 36 cases of cardiomyopathy, 9 cases of complex congenital heart disease (CHD), and 2 cases of cardiac tumor. Four patients received cardiac surgery before. The donors' average age was 20.89±11.84 years, including 19 donors under 18 years old and 28 donors over 18 years old. The mean donor/recipient body weight ratio was 1.58±0.58. The mean duration of intraoperative cardiopulmonary bypass (CPB) was 119.00±53.47 minutes, in which the mean CPB-assist time was 79.71±48.21 minutes. The average duration of postoperative mechanical ventilation was 32.00 (18.50-54.00) hours, and the average intensive care unit (ICU) stay was 7.00 (4.94-11.28) days. Postoperative complications occurred in 20 cases (42.55%). The 1-year, 3-year, and 5-year survival rate after operation was 95.74%, 93.01%, and 93.01% respectively.
Heart transplantation is an effective means for end-stage heart disease in children. The clinical outcome of pediatric heart transplantation in our center is satisfactory, with low incidence of postoperative complications and high short- and mid-term survival rates.
对中国一家中心的47例小儿心脏移植病例进行回顾性分析。
本研究纳入了2008年9月1日至2018年12月31日期间完成的47例18岁以下的心脏移植病例。我们对供体和受体的临床特征、围手术期信息、术后并发症以及短期和中期生存率进行了统计分析。
本研究包括24例男性和23例女性。移植时的平均年龄为10.34±4.80岁（最小3个月，中位数11.00岁）。术前诊断包括36例心肌病、9例复杂先天性心脏病（CHD）和2例心脏肿瘤。4例患者曾接受过心脏手术。供体的平均年龄为20.89±11.84岁，其中19例供体年龄在18岁以下，28例供体年龄在18岁以上。供体/受体平均体重比为1.58±0.58。术中体外循环（CPB）的平均持续时间为119.00±53.47分钟，其中CPB辅助时间平均为79.71±48.21分钟。术后机械通气的平均持续时间为32.00（18.50 - 54.00）小时，重症监护病房（ICU）的平均住院时间为7.00（4.94 - 11.28）天。20例（42.55%）发生术后并发症。术后1年、3年和5年生存率分别为95.74%、93.01%和93.01%。
心脏移植是小儿终末期心脏病的有效治疗手段。本中心小儿心脏移植的临床效果令人满意，术后并发症发生率低，短期和中期生存率高。
