德米霍夫现象。苏联和国外心脏移植的实验和临床病例(1968-1972)。苏联第二例临床心脏移植手术(Solovyev g.m., 1971年6月10日)

S. Glyantsev, Yu. A. Shabunts, M. I. Chernenko
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摘要

本文介绍了苏联和国外1968-1972年关于心脏移植实验和临床实践的医学文献资料。在1968年11月4日由A.A.维什涅夫斯基进行的心脏移植手术失败后,苏联进行了离体心脏保存的实验研究,以保持心脏的活力;建立大、小动物原位和异位心脏移植模型;观察移植心脏的形态、生理、生化及免疫学变化。这个国家的第二次心脏移植是由G.M. Solovyev在1971年6月10日进行的,但也没有成功。值得注意的是,德米霍夫副总统在实验性心脏移植方面的20年经验只得到了部分利用:许多外科医生将根据德米霍夫副总统的生物心脏保存技术分离出来的心肺复合体应用于实验动物。与此同时,1967年12月3日巴纳德成功进行心脏移植手术后,世界范围内的临床移植热潮开始了。1969年,进行了101次这样的手术。例如,D. Cooley在21个病人身上做了这种手术,在另一个病人身上做了两次手术。据观察,1968年接受手术的病人活了800-900天,甚至更长。R. Lower, M. DeBakey和N. Shumway给出了最好的结果。然而,绝大多数心脏移植在术后即刻或远期导致死亡。这导致成功移植的喜悦逐渐开始减弱:1969年只有47例手术,1970-1971年每年只有17例手术。
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PHENOMENON OF DEMIKHOV. Heart transplantation in experiment and clinical cases in the USSR and abroad (1968–1972). The Second in the USSR heart transplantation in a Clinic (Solovyev G.M., June 10, 1971)
The article presents materials of Soviet and foreign medical literature of 1968–1972 devoted to heart transplantation in experiment and clinical practice. It is shown that in the USSR after unsuccessful heart transplantation performed by A.A. Vishnevsky on November 4, 1968, experimental studies on isolated heart preservation in order to preserve its viability were conducted; models of orthotopic and heterotopic heart transplantation on large and small animals were created; morphological, physiological, biochemical and immunological changes in the transplanted heart were studied. The second heart transplantation in this country was performed by G.M. Solovyev on June 10, 1971, but it was also unsuccessful. It’s remarkable that the 20-year experience of V.P. Demikhov in experimental heart transplantation was used only partially: a number of surgeons applied the cardiopulmonary complex isolated according to V.P. Demikhov's technique for biological heart preservation in experimental animals. At the same time after the successful heart transplantation performed by C. Barnard on December 3, 1967, the world boom of clinical transplantation began. In 1969, 101 such operations were performed. For example, D. Cooley performed them on 21 patients and on another one performed two surgeries. There were observations that patients operated on in 1968 lived 800–900 days or more. The best results were shown by R. Lower, M. DeBakey and N. Shumway. However, the vast majority of heart transplants resulted in lethal outcomes in the immediate or distant postoperative period. This led to the fact that the euphoria of successful transplants gradually began to diminish: in 1969 only 47 operations were performed, and in 1970–1971 only 17 surgeries per year.
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