Royston D
Department of Cardiothoracic Anesthesia, Harefield Hospital, Middlesex, England.
J Heart Lung Transplant. 1993 Jan-Feb;12(1 Pt 1):S19-25.
Patients who undergo cardiothoracic transplantation represent a considerable challenge to any blood conservation program. It is well recognized that excessive bleeding increases the mortality and morbidity rates of any surgical procedure, but patients who undergo heart and lung transplantation, either singly or in combination, have a greater probability of bleeding more frequently and to a greater extent than patients who undergo many other types of surgery. In addition to the problems inherent in excessive bleeding are those associated with the need for increased donor blood transfusion requirements in these procedures. In this regard it is imperative to avoid the transmission of any blood-borne infection to a patient who is immunosuppressed. In particular, the cytomegalovirus is a key problem. With large blood losses and in patients with uncommon blood groups, it may not be possible to guarantee unlimited supplies of cytomegalovirus-negative blood.
接受心胸移植的患者对任何血液保护方案来说都是一个巨大的挑战。人们普遍认识到，过度出血会增加任何外科手术的死亡率和发病率，但接受心脏和肺移植（无论是单独移植还是联合移植）的患者比接受许多其他类型手术的患者更有可能更频繁、更大量地出血。除了过度出血所固有的问题外，这些手术还存在因需要增加供体输血需求而带来的问题。在这方面，必须避免将任何血源性感染传播给免疫抑制患者。特别是巨细胞病毒是一个关键问题。在大出血的情况下以及血型罕见的患者中，可能无法保证无限供应巨细胞病毒阴性血液。
