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部分心脏移植的适应症及实际考量

Indications and Practical Considerations for Partial Heart Transplantation.

作者信息

Rajab Taufiek Konrad, Kalfa David M, Mery Carlos M, Emani Sitaram M, Reemtsen Brian L

机构信息

Division of Cardiovascular Surgery, Department of Surgery, Arkansas Children's Hospital, Little Rock, Arkansas.

Section of Pediatric and Congenital Cardiac Surgery, Division of Cardiac, Thoracic, and Vascular Surgery, Department of Surgery, Morgan Stanley Children's Hospital, New York, New York.

出版信息

Ann Thorac Surg. 2025 Mar 17. doi: 10.1016/j.athoracsur.2025.01.037.

Abstract

Partial heart transplantation is a new approach to deliver growing heart valve substitutes for children. The rationale for partial heart transplantation is that the valves contained in heart transplants grow. Partial heart transplants differ from heart transplants because only the part of the heart containing the necessary valve is transplanted, while the native ventricles are preserved. Preserving the native ventricles eliminates the risk of graft ventricular dysfunction and allows for utilization of donor hearts with ventricular dysfunction. Here we outline practical considerations for partial heart transplantation, including indications, sources for donor hearts, graft procurement, graft preservation, implantation, recipient immunosuppression, and reimbursement. This invited expert review is intended to help clinical teams implement partial heart transplantation.

摘要

部分心脏移植是为儿童提供不断生长的心脏瓣膜替代物的一种新方法。部分心脏移植的基本原理是心脏移植中所含的瓣膜会生长。部分心脏移植与心脏移植不同,因为仅移植包含所需瓣膜的那部分心脏,而保留自身的心室。保留自身心室可消除移植心室功能障碍的风险,并允许使用存在心室功能障碍的供体心脏。在此,我们概述了部分心脏移植的实际注意事项,包括适应症、供体心脏来源、移植物获取、移植物保存、植入、受体免疫抑制和报销。这篇特邀专家综述旨在帮助临床团队实施部分心脏移植。

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本文引用的文献

1
Partial Heart Transplant Growth and Hemodynamic Function in Piglets.
JACC Basic Transl Sci. 2024 Dec 5;10(4):502-4. doi: 10.1016/j.jacbts.2024.10.015.
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