Sander Sukhjot, Singer-Englar Tahli, Nishihara Keith, Esmailian Fardad, Patel Jignesh K, Kobashigawa Jon A, Kittleson Michelle M
Department of Internal Medicine, Smidt Heart Institute, Cedars-Sinai, Los Angeles, California.
Cedars-Sinai Medical Center, the Department of Cardiology, Smidt Heart Institute, Cedars-Sinai, Los Angeles, California.
J Heart Lung Transplant. 2021 Jul;40(7):575-579. doi: 10.1016/j.healun.2021.03.014. Epub 2021 Mar 21.
Heart transplantation (HTx) improves quality of life and survival in patients with advanced heart failure. Jehovah's Witnesses (JW) patients decline blood transfusion (including red cells, plasma and platelets) and are prohibited from heart transplantation at many centers. We report our experience with 20 consecutive JW patients with advanced heart failure who declined blood products referred to our center for HTx consideration. Of these, 7 were declined for transplant due to prior sternotomy, need for multi-organ transplant, or being too well. Of 13 JW patients accepted for heart transplant listing, 8 underwent HTx at our center. Compared to non-JW controls without prior cardiac surgery matched for age and listing status, JW HTx recipients had comparable incidence of primary graft dysfunction, rejection, allograft vasculopathy, and survival and hemoglobin up to 1 year. With appropriate selection, patients who are JW and decline blood products may successfully undergo heart transplantation.
心脏移植（HTx）可改善晚期心力衰竭患者的生活质量并提高其生存率。耶和华见证人（JW）患者拒绝输血（包括红细胞、血浆和血小板），在许多中心被禁止进行心脏移植。我们报告了连续20例拒绝血液制品的晚期心力衰竭JW患者转诊至我院考虑进行HTx的经验。其中，7例因既往胸骨切开术、需要多器官移植或状况过好而被拒绝移植。在13例被接受列入心脏移植名单的JW患者中，8例在我院接受了HTx。与年龄和列入名单状态相匹配的无心脏手术史的非JW对照相比，JW HTx受者的原发性移植物功能障碍、排斥反应、同种异体移植物血管病变的发生率以及生存率和血红蛋白水平在1年内相当。经过适当选择，拒绝血液制品的JW患者可能成功接受心脏移植。
