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【medical-news】肥大的心脏也可用来移植
By Anthony J. Brown, MD
NEW YORK (Reuters Health) Mar 20 - Cardiac allografts with mild or moderate left ventricular hypertrophy (LVH) can be safely transplanted without impairing survival, according to a report in the Journal of the American College of Cardiology for March 25. This is important because increased usage of hypertrophied hearts could expand the donor pool.
"The biggest finding was that recipients of donor hearts with LVH fared as well as recipients of hearts that had no LVH. This was a surprising finding because most investigators assume that LVH is always detrimental when present," study co-author Dr. Lawrence S. C. Czer told Reuters Health.
He explained that the reason may involve how LVH differs between older adults and younger individuals, who are frequently the source of donor hearts. In older adults, LVH is typically related to a pathologic process, such as coronary artery disease or hypertension. In younger individuals, by contrast, the LVH is often physiologic, representing the response to exercise demands.
The study involved 62 patients who received a heart with LVH and 365 who received one without LVH. The average recipient and donor ages were 56 and 30 years, respectively, and the median follow-up period was 3.8 years.
Donors with LVH were significantly older and had higher rates of intracranial hemorrhage than donors without LVH. Forty-two percent of donors with LVH had mild hypertrophy, 53% had moderate hypertrophy, and 5% had severe hypertrophy.
The 1-year survival rates for recipients of a LVH and non-LVH heart were 97% and 91%, respectively (p = NS). The corresponding 5-year survival rates were 84% and 70% (p = NS).
Echocardiographic assessment showed that significant regression of LVH occurred following transplantation, the report indicates.
"The take-home message is that the finding of mild-to-moderate LVH in a donor heart is not a contraindication to heart transplantation, and that the LVH regresses over time in the majority of recipients after the transplant," Dr. Czer, from the Cedars-Sinai Medical Center in Los Angeles, said.
"Questions to be addressed in future studies include determination of whether all donors with mild-to-moderate LVH are safe to use for heart transplantation, or whether there might be certain subgroups (for example, older donors) where the use of such donor hearts would not be safe and would result in a poor outcome."
J Am Coll Cardiol 2008;51:1214-1220.
http://www.medscape.com/viewarticle/571739 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领 Hypertrophied Hearts Can Be Safe for Transplantation
肥大的心脏可以安全地用于心脏移植
By Anthony J. Brown, MD
NEW YORK (Reuters Health) Mar 20 - Cardiac allografts with mild or moderate left ventricular hypertrophy (LVH) can be safely transplanted without impairing survival, according to a report in the Journal of the American College of Cardiology for March 25. This is important because increased usage of hypertrophied hearts could expand the donor pool.
据发表在美国心脏病学研究杂志的一个报道说,轻中度右室肥大的心脏异体移植物可以在不影响生存率的前提下安全的用于心脏移植,这增加了肥大心脏的可用性,扩大了心脏移植供体库.
"The biggest finding was that recipients of donor hearts with LVH fared as well as recipients of hearts that had no LVH. This was a surprising finding because most investigators assume that LVH is always detrimental when present," study co-author Dr. Lawrence S. C. Czer told Reuters Health.
最大的发现是,接受LVH心脏的受体和接受无LVH的受体预后无差异,这是一个惊人的发现,因为,大多数研究者都认为,LVH作为供心往往是有害的,研究合作作者Lawrence s.c博士对Reuters Health说.
He explained that the reason may involve how LVH differs between older adults and younger individuals, who are frequently the source of donor hearts. In older adults, LVH is typically related to a pathologic process, such as coronary artery disease or hypertension. In younger individuals, by contrast, the LVH is often physiologic, representing the response to exercise demands.
他解释说,其原因可能包括年老成年供体和年轻成年供体存在多大的差异,他们往往是供心得主要来源.在年老供者,LVH与冠心病或者高血压等疾病高度相关,相比之下,在年轻供者,LVH一般是生理性的,是对运动需要的反应性肥大.
The study involved 62 patients who received a heart with LVH and 365 who received one without LVH. The average recipient and donor ages were 56 and 30 years, respectively, and the median follow-up period was 3.8 years.
此项研究对象为62名接受LVH供心和365名接受无LVH供心的心脏移植病人.受者和供者平均年龄分别为56和30岁,中位随访期为3.8年.
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作者:admin@医学,生命科学 2011-01-04 05:14
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