Pham S M, Kormos R L, Murali S, Kawai A, Demetris A J, Hattler B G, Williams P A, McNamara D, Rosenblum W, Fricker F J
University of Pittsburgh, Pennsylvania, USA.
Clin Transpl. 1994:121-5.
During the past 14 years, 746 hearts have been transplanted at the University of Pittsburgh. Immunosuppression has evolved from a CsA-based protocol with or without lympholytic prophylaxis to a tacrolimus-based protocol. Tacrolimus offers comparable survival to the conventional immunosuppression but is associated with lesser side effects and lower recurrent rejection. It also serves as an effective rescue agent for intractable rejection in patients receiving CsA-based immunosuppression. However, the shortage of donors, chronic rejection, and the morbidity associated with chronic use of nonspecific immunosuppression remain the major limitations in clinical transplantation. Currently, research at the University of Pittsburgh focuses on the induction of donor-specific transplantation tolerance in order to eliminate the morbidity associated with nonspecific immunosuppression and on left ventricular-assist devices as a bridge and/or an alternative to cardiac transplantation.
在过去14年里，匹兹堡大学共进行了746例心脏移植手术。免疫抑制方案已从基于环孢素A（CsA）并辅以或不辅以淋巴细胞溶解预防措施，发展到基于他克莫司的方案。他克莫司与传统免疫抑制方案相比，具有相当的生存率，但副作用较小，移植排斥反应复发率较低。它还可作为接受基于CsA免疫抑制治疗的患者顽固性排斥反应的有效抢救药物。然而，供体短缺、慢性排斥反应以及长期使用非特异性免疫抑制剂相关的发病率，仍然是临床移植的主要限制因素。目前，匹兹堡大学的研究重点是诱导供体特异性移植耐受，以消除与非特异性免疫抑制相关的发病率，以及将左心室辅助装置作为心脏移植的桥梁和/或替代方案。
