Clinical analysis of 36 patients with allograft orthotopic heart transplantation / 中国胸心血管外科临床杂志

@#Objective    To analyze the clinical effects of allograft orthotopic heart transplantation. Methods    The clinical data of 36 patients with allograft orthotopic heart transplantation performed in the Heart Centre of Nanjing First Hospital from January 1, 2014 to January 1, 2019 were retrospectively analyzed. There were 31 males and 5 females, aged 23-65 (46.2±8.8) years. Protopathy diseases of recipients included dilated cardiomyopathy in 33 patients, end-stage coronary heart disease in 2 patients, and end-stage valvular heart disease in 1 patient. Heart transplantations were performed through double vena cava anastomosis. Immune induction during operations was treated with a combination therapy of both bariximab and methylprednisolone. Postoperatively, all patients were treated with a new triple immunosuppression protocol: FK506+cellcept+prednisone. Results    During the perioperative period, 1 patient died of severe infection. For 8 patients with heart failure, after adjustment and intra-aortic balloon pump, the cardiac function of all the 8 patients improved. For 5 patients with renal failure, after continuous renal replacement therapy, the renal function of all the patients returned to normal. One patient died of graft failure after 1 year of follow-up. The follow-up time for each patient postoperatively differed from 3 to 49 months with an average time of 16±4 months while the 1-year survival rate was 97.1% (34/35). Among them, 10 patients were marginal donors, with no significant differences between conventional donors and them. Conclusion     For end-stage heart diseases, heart transplantation is one of the effective treatment methods in China with fine early- and middle-term curative effects. Reasonable application of intra-aortic balloon pump, continuous renal replacement therapy and other adjuvant treatments and the new triple immunosuppression protocol can significantly improve the success rate of heart transplantation, reduce the occurrence of acute and chronic rejections. The application of marginal donors can alleviate the current situation of shortage of donors to some extent.

Combined Heart and Liver Transplantation: The Asan Medical Center Experience / 대한이식학회지

Combined heart-liver transplantation (CHLT) is an increasingly accepted treatment for select patients with advanced heart and liver disease. However, CHLT are infrequently performed, despite growing optimism about their effectiveness. Here, we report Asan Medical Center experience with CHLT in three patients presenting with advanced heart and liver failure. One patient died of brain swelling because of intractable hyperammonemia on postoperative day 9. The two other patients were still alive at 53 and 9 months postsurgery. None of these patients required readmission for cardiac or hepatic graft dysfunction and no rejection episodes were detected on routine cardiac biopsies. This is the first report of CHLT cases from Korea.

Progress of the mechanism study of partial left ventriculectomy / 医学研究生学报

Partial left ventriculectomy(PLV),also named as left ventricular volume reduction or the Batista procedure,is gradually used as a new alternative method to treat end-stage heart disease.This article summarizes the progress of the mechanism of partial left ventriculectomy with rapid left ventricle reshaping and hemodynamics change and patho-physiological effect etc.