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心胸外科的先驱——巴西东北部心脏移植项目

A Pioneer of Cardiothoracic Surgery - the Brazilian Northeast Heart Transplant Program.

作者信息

de Ricardo, de José Teles, Wanderley José, de Mozart Augusto Soares, Lobo José Glauco, de José Ricardo Lagreca

机构信息

Department of Thoracic Surgery, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil.

Department of Thoracic Surgery, Universidade de Pernambuco (UPE), Recife, Pernambuco, Brazil.

出版信息

Braz J Cardiovasc Surg. 2025 May 30;40(4):e2024128. doi: 10.21470/1678-9741-2024-0128.

Abstract

This review highlights the pivotal milestones in the development of cardiac transplantation and related techniques. Beginning with Alexis Carrel's pioneering work on vascular anastomosis and organ preservation, the narrative progresses through groundbreaking achievements such as John Gibbon's invention of the heart-lung machine in 1953 and James Hardy's daring chimpanzee-to-human heart transplant in 1964. The story culminates in Christiaan Barnard's historic human heart transplant in 1967 and Euryclides Zerbini's leadership in bringing this innovation to Brazil in 1968. Key advancements include the development of orthotopic heart transplantation techniques by Richard Lower and Norman Shumway and the resurgence of heart transplants following the introduction of cyclosporine in 1983, which revolutionized organ rejection management. The collaborative Programa Nordeste de Transplante Cardíaco, initiated in 1986, exemplifies regional innovation in overcoming logistical and financial barriers in Brazil. Recent progress, such as the first successful xenotransplantation using a genetically modified pig heart in 2022, underscores ongoing efforts to address donor shortages and improve transplant outcomes. This narrative is a testament to human ingenuity and perseverance in offering life-saving solutions to end-stage heart disease.

摘要

本综述重点介绍了心脏移植及相关技术发展中的关键里程碑。从亚历克西斯·卡雷尔在血管吻合和器官保存方面的开创性工作开始,叙述了一系列开创性成就,如1953年约翰·吉本发明心肺机以及1964年詹姆斯·哈代大胆进行的黑猩猩到人类的心脏移植。故事的高潮是1967年克里斯蒂安·巴纳德进行的具有历史意义的人类心脏移植,以及1968年尤里克莱德斯·泽尔比尼将这一创新引入巴西并发挥的领导作用。关键进展包括理查德·洛厄尔和诺曼·舒姆韦开发的原位心脏移植技术,以及1983年环孢素引入后心脏移植的复兴,这彻底改变了器官排斥反应的管理。1986年启动的东北心脏移植合作项目体现了巴西在克服后勤和资金障碍方面的区域创新。最近的进展,如2022年首次成功使用基因编辑猪心脏进行异种移植,凸显了为解决供体短缺问题和改善移植结果而持续做出的努力。这一叙述证明了人类在为终末期心脏病提供救生解决方案方面的智慧和毅力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3fa/12124810/6205d6380b5e/bjcvs-40-04-e20240128-g01.jpg

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