Barghash Maya H, Pinney Sean P
1Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, USA.
2The Mount Sinai Hospital, 1190 Fifth Avenue, Box 1030, New York, NY 10029 USA.
Curr Transplant Rep. 2020;7(1):12-17. doi: 10.1007/s40472-019-00257-y. Epub 2019 Dec 17.
To describe the incidence and epidemiology of heart retransplantation in adults and children and to review the risk factors associated with adverse outcome following retransplantation to help guide recipient selection.
Heart retransplantation is associated with inferior short-term and long-term survival when compared with primary heart transplantation and its use remains controversial although less so in the pediatric heart transplant population.
In the most recent era of heart transplantation, patients retransplanted for CAV, greater than 1 year from their primary transplant, and who are not in critical condition have improved survival compared with other retransplant recipients. Survival with retransplantation can approach that of primary transplantation when patients are appropriately selected. More research is needed regarding the optimal timing for retransplantation and the optimal management for patients after retransplantation.
描述成人及儿童心脏再次移植的发生率和流行病学情况，并回顾再次移植后不良结局的相关危险因素，以帮助指导受体选择。
与初次心脏移植相比，心脏再次移植的短期和长期生存率较低，尽管在小儿心脏移植人群中争议较小，但心脏再次移植的应用仍存在争议。
在心脏移植的最新时代，因冠状动脉血管病变进行再次移植、距初次移植超过1年且病情不危急的患者，与其他再次移植受体相比，生存率有所提高。当患者选择适当时，再次移植后的生存率可接近初次移植。关于再次移植的最佳时机以及再次移植后患者的最佳管理，还需要更多研究。
