Reemtsma K, Hardy M A, Drusin R E, Smith C R, Rose E A
Ann Surg. 1985 Oct;202(4):418-24. doi: 10.1097/00000658-198510000-00003.
This study reports the authors' experience with 66 heart transplants in 64 patients done over an 8-year period (1977-1985). In the early series, a high frequency of complications involving serious infections was noted. In April 1983, the immunosuppressive regimen was changed to cyclosporine and low-dose steroids. Patients were monitored with frequent myocardial biopsies and determinations of serum cyclosporine levels. Although this is not a controlled study, the authors believe that the improved results, including reduced frequency and severity of infections, are related to altered immune suppression. They speculate that patients with successful cardiac grafts develop a form of specific unresponsiveness and now are studying the mechanisms of this adaptation.
本研究报告了作者在1977年至1985年的8年期间对64例患者进行66例心脏移植的经验。在早期系列中，注意到涉及严重感染的并发症发生率很高。1983年4月，免疫抑制方案改为环孢素和低剂量类固醇。通过频繁的心肌活检和血清环孢素水平测定对患者进行监测。虽然这不是一项对照研究，但作者认为，包括感染频率和严重程度降低在内的结果改善与免疫抑制的改变有关。他们推测，心脏移植成功的患者会形成一种特异性无反应状态，目前正在研究这种适应的机制。
