Kawauchi M, Gundry S R, de Begoña J A, Razzouk A J, Bailey L L
Department of Surgery, School of Medicine, Loma Linda University Medical Center, Calif. 92354.
J Heart Lung Transplant. 1993 Mar-Apr;12(2):185-8.
The efficacy of using infant donors with an extended cardiopulmonary resuscitation (CPR) history was investigated. Eight heart transplantations with donors who had no or minimal (less than 10 minutes) history of CPR (group A) and seven heart transplantations with donors with extended CPR history (35 to 125 minutes; mean, 59 minutes; group B) were compared for peak myosin levels after transplantation, and systolic and diastolic cardiac function in the first week after transplantation. All donor hearts had normal hemodynamics in the early postoperative period. No significant differences were found between the groups with regard to age of donors, age of recipients, donor heart ischemic time, and cardiac function in the first week after transplantation. In group B, peak myosin levels were 1.4, 4.6, 7.0, 11.3, 14.8, 20.2, and 21.3 ng/ml. These values were significantly (p < 0.05) higher than those in group A but represented only minimal myocardial damage when compared with the values in previous myocardial infarction studies. Although donors with a history of protracted CPR had higher efflux of myosin light chains perioperatively, hemodynamic recovery suggests that use of pediatric donor heart grafts after prolonged CPR is safe and efficacious.
研究了使用有延长心肺复苏（CPR）史的婴儿供体的疗效。比较了8例接受无或仅有短暂（少于10分钟）CPR史供体心脏移植的患者（A组）和7例接受延长CPR史（35至125分钟；平均59分钟）供体心脏移植的患者（B组）移植后的肌球蛋白峰值水平，以及移植后第一周的心脏收缩和舒张功能。所有供体心脏术后早期血流动力学均正常。两组在供体年龄、受体年龄、供体心脏缺血时间以及移植后第一周的心脏功能方面均未发现显著差异。在B组中，肌球蛋白峰值水平分别为1.4、4.6、7.0、11.3、14.8、20.2和21.3 ng/ml。这些值显著高于A组（p < 0.05），但与既往心肌梗死研究中的值相比，仅代表轻微的心肌损伤。尽管有延长CPR史的供体围手术期肌球蛋白轻链外流量较高，但血流动力学恢复表明，延长CPR后使用小儿供体心脏移植物是安全有效的。
