Department of Surgery, Duke University Medical Center, Durham, NC, USA.
Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA.
World J Pediatr Congenit Heart Surg. 2024 Sep;15(5):597-603. doi: 10.1177/21501351241245115. Epub 2024 May 23.
Partial heart transplantation is a new approach to deliver growing heart valve implants. Partial heart transplants differ from heart transplants because only the part of the heart containing the necessary heart valve is transplanted. This allows partial heart transplants to grow, similar to the valves in heart transplants. However, the transplant biology of partial heart transplantation remains unexplored. This is a critical barrier to progress of the field. Without knowledge about the specific transplant biology of partial heart transplantation, children with partial heart transplants are empirically treated like children with heart transplants because the valves in heart transplants are known to grow. In order to progress the field, an animal model for partial heart transplantation is necessary. Here, we contribute our surgical protocol for partial heart transplantation in growing piglets. All aspects of partial heart transplantation, including the donor procedure, the recipient procedure, and recipient perioperative care are described in detail. There are important nuances in the conduct of virtually all aspects of open heart surgery that differs in piglets from humans. Our surgical protocol, which is based on our experience with 34 piglets, will allow other investigators to leverage our experience to seek fundamental knowledge about the nature of partial heart transplants. This is significant because the partial heart transplant model in piglets is complex and very resource intensive.
部分心脏移植是一种为心脏瓣膜植入物提供生长空间的新方法。部分心脏移植与心脏移植不同，因为只有包含必要心脏瓣膜的心脏部分被移植。这使得部分心脏移植能够像心脏移植中的瓣膜一样生长。然而，部分心脏移植的移植生物学仍然没有得到探索。这是该领域进展的一个关键障碍。由于缺乏关于部分心脏移植特定移植生物学的知识，部分心脏移植的儿童是根据心脏移植的儿童经验性治疗的，因为已知心脏移植中的瓣膜会生长。为了推进该领域，需要一个部分心脏移植的动物模型。在这里，我们提供了在生长中的小猪中进行部分心脏移植的手术方案。详细描述了部分心脏移植的各个方面，包括供体程序、受体程序和受体围手术期护理。在小猪和人类的心脏直视手术的几乎所有方面的实施中，都存在重要的细微差别。我们的手术方案是基于我们对 34 头小猪的经验，这将使其他研究人员能够利用我们的经验来寻求关于部分心脏移植性质的基本知识。这是非常重要的，因为小猪的部分心脏移植模型非常复杂，资源密集度很高。
