Hetzer R, Loebe M, Hummel M, Franz N, Schueler S, Friedel N, Hennig E
German Heart Institute Berlin.
Clin Transpl. 1993:129-35.
Heart transplantation has become a routine procedure. Surgical techniques have been standardized and triple-drug immunosuppression has proven to be the most effective posttransplantation medical treatment. A shortage of donor organs has remained the major factor inhibiting extensive application of heart transplantation. Improved techniques of organ protection may eventually contribute to an extension of the donor pool. However, it seems to be more important to develop alternative procedures further (artificial heart, xenotransplantation, extended use of conservative surgical or medical treatment). The patient population undergoing heart transplantation will undoubtedly include more older, severely ill, polymorbid patients who are not suitable for alternative procedures. Pediatric heart transplantation may increase in the coming years and mechanical circulatory support will surely gain in importance for both adult and pediatric patients awaiting heart transplantation.
心脏移植已成为一种常规手术。手术技术已标准化，三联药物免疫抑制已被证明是移植后最有效的药物治疗方法。供体器官短缺仍然是抑制心脏移植广泛应用的主要因素。改进的器官保护技术最终可能有助于扩大供体库。然而，进一步开发替代程序（人工心脏、异种移植、扩大保守手术或药物治疗的应用）似乎更为重要。接受心脏移植的患者群体无疑将包括更多不适合替代程序的老年、重症、患有多种疾病的患者。未来几年，小儿心脏移植可能会增加，机械循环支持对于等待心脏移植的成人和小儿患者肯定会变得更加重要。
