Pennock J L, Oyer P E, Reitz B A, Jamieson S W, Bieber C P, Wallwork J, Stinson E B, Shumway N E
J Thorac Cardiovasc Surg. 1982 Feb;83(2):168-77.
Two hundred twenty-seven cardiac transplant procedures have been performed in 206 patients from January, 1968, to April, 1981. Postoperative survival rates, calculated by the actuarial method for program years 1968 to 1973 (66 patients), are 44%, 33%, 27%, 21%, and 18% at 1, 2, 3, 4, and 5 years after transplantation, respectively. Postoperative survival rates for program years 1974 to 1981 (140 patients) are 63%, 55%, 51, 44%, and 39% at 1, 2, 3, 4, and 5 years after transplantation, respectively. This increase results primarily from improvement in survival achieved in the first 3 postoperative months (59% +/- 7%, 1968 to 1973, versus 80% +/- 40%, 1974 to 1980), reflecting improved patient management. Infection remains the primary cause of death following transplantation (76/131 patients, 58%), followed by acute rejection (24/181, 18.3%), graft arteriosclerosis (14/131, 10.7%), and malignancy (6/131, 4.6%). The development of graft arteriosclerosis has been examined in 85 one-year survivors studied by annual coronary arteriograms. Coronary lesions of varying severity have developed in 21 patients. HLA-A2 incompatibility was associated with a higher incidence of graft arteriosclerosis than was apparent for all other A locus incompatibilities (p less than 0.0003). Lymphoma has been shown to be associated with younger recipient age, a primary disease diagnosis of idiopathic cardiomyopathy, and retransplantation. One hundred six patients have survived at least 1 year after transplantation; 97% were in NYHA Class 1 at that time interval and 82% returned to employment or activity of choice. The longest survival time is new 11 years, 3 months. Cardiac transplantation can be considered "reasonable and therapeutic treatment to extend life" in selected individuals.
1968年1月至1981年4月期间，206名患者接受了227例心脏移植手术。采用精算方法计算1968年至1973年（66例患者）的术后生存率，移植后1年、2年、3年、4年和5年的生存率分别为44%、33%、27%、21%和18%。1974年至1981年（140例患者）的术后生存率在移植后1年、2年、3年、4年和5年分别为63%、55%、51%、44%和39%。这种提高主要源于术后前3个月生存率的改善（1968年至1973年为59%±7%，1974年至1980年为80%±4%），反映了患者管理的改善。感染仍然是移植后死亡的主要原因（76/131例患者，58%），其次是急性排斥反应（24/181例，18.3%）、移植血管硬化（14/131例，10.7%）和恶性肿瘤（6/131例，4.6%）。对85名接受年度冠状动脉造影检查的1年存活者进行了移植血管硬化发展情况的研究。21例患者出现了不同严重程度的冠状动脉病变。与所有其他A位点不相容性相比，HLA - A2不相容性与移植血管硬化的发生率更高相关（p<0.0003）。已证明淋巴瘤与受者年龄较小、原发性疾病诊断为特发性心肌病以及再次移植有关。106例患者移植后至少存活1年；在此时间段内，97%的患者纽约心脏协会（NYHA）心功能分级为1级，82%的患者恢复了工作或选择的活动。最长存活时间为11年3个月。对于选定的个体，心脏移植可被视为“延长生命的合理且治疗性的治疗方法”。
