Watson D C, Reitz B A, Oyer P E, Stinson E B, Shumway N E
Transplantation. 1980 Dec;30(6):401-3. doi: 10.1097/00007890-198012000-00002.
Between January 1968 and March 1980, 202 hearts had been transplanted into 185 patients at Stanford University Medical Center. Occasionally, patients after transplantation develop myocardial failure which is amenable only to retransplantation. Sixteen patients underwent initial orthotopic allograft using standard techniques. Eight patients developed accelerated arteriosclerotic coronary disease, six had unrelenting rejection, and two had donor heart dysrrhythmia or right ventricular failure requiring retransplantation. One patient required a third transplant because of donor left ventricular ischemia. All sequential transplants were managed similarly to the primary transplant. Of the initial transplant hearts at risk, 60% survived for more than 1 year, and 57% survived for more than 2 years. These results are similar to those of patients not requiring retransplantation. Of the secondary transplant hearts at risk, 31% survived for more than 1 year and 29% survived for more than 2 years. The severity of infection and/or rejection contributed most significantly to secondary heart transplant mortality. Sequential orthotopic cardiac transplantation offers an acceptable alternative to patients with allograft failure. Survival is not as favorable as with initial transplantation because of the prolonged immunosuppression during sequential transplantation.
1968年1月至1980年3月期间，斯坦福大学医学中心为185名患者移植了202颗心脏。偶尔，移植后的患者会出现心肌衰竭，而这只能通过再次移植来治疗。16名患者采用标准技术接受了初次原位同种异体移植。8名患者出现加速性动脉硬化性冠状动脉疾病，6名患者持续存在排斥反应，2名患者因供体心脏心律失常或右心室衰竭需要再次移植。1名患者因供体左心室缺血需要进行第三次移植。所有序贯移植的处理方式与初次移植相似。在有风险的初次移植心脏中，60%存活超过1年，57%存活超过2年。这些结果与不需要再次移植的患者相似。在有风险的二次移植心脏中，31%存活超过1年，29%存活超过2年。感染和/或排斥反应的严重程度对二次心脏移植死亡率的影响最为显著。序贯原位心脏移植为同种异体移植失败的患者提供了一种可接受的替代方案。由于序贯移植期间免疫抑制时间延长，其生存率不如初次移植。
