Stevenson L W
Cardiomyopathy and Transplant Center, Bringham & Women's Hospital, Boston, MA 02115, USA.
Curr Opin Cardiol. 1996 Mar;11(2):166-73. doi: 10.1097/00001573-199603000-00010.
The increasing discrepancy between the donor hearts available and the number of patients with advanced heart failure underscores the need to optimize medical therapy and restrict the option of cardiac transplantation to patients with heart failure refractory to maximal conventional therapy. New medical and surgical therapies should be studied specifically in this population. The need for heart transplantation in ambulatory patients with severe heart failure is better assessed by the serial evaluation of objective measures of clinical stability and peak exercise oxygen consumption, than by assessment of standard risk factors at the time of patient referral. Among comorbidities which may preclude transplantation, psychosocial risk factors have recently undergone stricter scrutiny. The successful outcome of candidates for heart transplantation requires serial assessment and continuity of care by a dedicated team of health professionals specialized in heart failure and transplantation.
可用供体心脏数量与晚期心力衰竭患者数量之间日益增大的差距凸显了优化药物治疗以及将心脏移植选项限制于对最大程度常规治疗无效的心力衰竭患者的必要性。应专门针对这一人群研究新的药物和手术治疗方法。对于门诊严重心力衰竭患者，通过对临床稳定性和峰值运动耗氧量等客观指标进行连续评估，比在患者转诊时评估标准风险因素，能更好地评估心脏移植的必要性。在可能排除移植的合并症中，社会心理风险因素最近受到了更严格的审查。心脏移植候选者的成功预后需要由专门从事心力衰竭和移植的专业医疗团队进行连续评估和持续护理。
