长时间冷缺血心脏移植的中期和长期预后

A. Fomichev, V. Poptsov, D. Sirota, M. Zhulkov, A. Edemskiy, А. V. Protopopov, V. Y. Kliver, A. Skokova, A. Chernyavskiy, D. Khvan, K. Agayeva
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引用次数: 1

摘要

目的:比较分析心脏移植术后长时间和短时间冷缺血的远期预后。材料和方法。我们分析了29例原位HT伴bbbb4小时冷缺血的数据。移植手术于2013年至今在Meshalkin国家医学研究中心进行。器官来自其他地区的捐赠者。对照组29例HTs冷缺血4小时的预后不差于短缺血组。这为进一步积累利用来自偏远地区的心脏捐献者的经验提供了依据。
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Mid-term and long-term outcomes following heart transplantation with prolonged cold ischemia
Objective: comparative analysis of long-term outcomes following heart transplantation (HT) with prolonged and short cold ischemia.Materials and methods. We analyzed the data of 29 orthotopic HT with >4 hours of cold ischemia. The transplant surgery was performed at Meshalkin National Medical Research Center between 2013 and the present time. Organs were obtained from donors from other regions. The control group consisted of 29 HTs with cold ischemia <4 hours, performed in the same period. The minimum distance between the transplant center and the donor base was about 250 km (Barnaul); the maximum distance was about 850 km (Krasnoyarsk). Recipient survival and postoperative peculiarities were analyzed.Results. In-hospital survival in the prolonged cold ischemia group was 89.7% (n = 26) with 3 deaths (10.3%). In the second group (<240 min), in-hospital survival was 79.3% (n = 23) with 6 (20.7%) deaths. The Kaplan-Meier survival analysis showed no difference between the groups (Log-Rank Test, P 1/4 0.59). In addition, cold ischemia time did not increase the risk of graft rejection and the risk of transplant coronary artery disease (TCAD).Conclusion. HT with cold ischemia >4 hours did not have worse outcomes than in short graft ischemia. This provides grounds for further accumulation of experience in the use of heart donors from remote locations.
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