Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
ESC Heart Fail. 2023 Apr;10(2):1431-1434. doi: 10.1002/ehf2.14238. Epub 2022 Nov 20.
Heart transplantation (HTx) remains the gold standard treatment for end-stage heart failure in children but is restricted due to the limitation of donors. The donor-recipient weight ratio (DRWR) of 0.8-2.5 was the main selection criterion, and reports were particularly scarce in cases of DRWR > 3.0. We present an infant HTx case with DRWR of 6.5. The recipient was a 66-day-old female infant, weighing 3 kg, diagnosed with complex congenital heart disease and refractory severe heart failure, whereas the donor was a 4-year-old girl weighing 19.5 kg. The phased delayed sternal closure was performed and accomplished on the 23rd day after operation without wound infection. After treating complications with extracorporeal membrane oxygenation, peritoneal dialysis, and mechanical ventilation, the patient was successfully discharged. After 1 year of follow-up, the patient was still in optimal condition. Extending DRWR range may help enlarge the donor pool and shorten recipients' waiting time.
心脏移植（HTx）仍然是儿童终末期心力衰竭的金标准治疗方法，但由于供体的限制，其应用受到限制。供体与受者体重比（DRWR）为 0.8-2.5 是主要的选择标准，而 DRWR>3.0 的报告尤其罕见。我们报告了一例 DRWR 为 6.5 的婴儿 HTx 病例。该受者为 66 天大的女婴，体重 3 公斤，诊断为复杂先天性心脏病和难治性严重心力衰竭，而供者为 4 岁女孩，体重 19.5 公斤。采用分阶段延迟胸骨闭合术，在术后第 23 天完成，无伤口感染。在使用体外膜氧合、腹膜透析和机械通气治疗并发症后，患者成功出院。随访 1 年后，患者情况仍然最佳。扩大 DRWR 范围可能有助于扩大供体库并缩短受者的等待时间。
