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成年人与先天性心脏病和移植:挑战,机遇和政策
Nicole Herrick1, Marcus Urey1, Laith Alshawabkeh2
1Division of Cardiovascular Medicine, Department of Medicine, University of Calilfornia San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143, USA.
Heart failure clinics
|March 10, 2024
概括
对于患有先天性心脏病 (ACHD) 的成年人来说,心脏移植正在增加. 虽然最初的生存是具有挑战性的,但在ACHD患者的第一年后,长期结果显著改善.
科学领域:
- 心脏病学 心脏病学
- 移植医学 移植医学
- 成年人的先天性心脏病
背景情况:
- 在患有先天性心脏病 (ACHD) 的成年人中,心脏移植的发生率正在增加.
- 在ACHD患者中,移植后的死亡率仍然高于非ACHD患者,特别是在第一年内.
研究的目的:
- 审查心脏移植患者心脏移植的挑战和策略.
- 强调为这一群体提供专业护理和分配方面的重要性.
主要方法:
- 关于心脏移植在ACHD中的当前文献和临床实践的审查.
- 对ACHD患者的生存数据和分配系统优先级的分析.
主要成果:
- 与非ACHD患者相比,ACHD患者面临更高的早期死亡率,但在移植后的第一年后显示出优异的长期存活率.
- 优化移植前评估和术后规划可以降低风险.
- 目前的器官分配系统提供优先权,但对于复杂的病例,如Fontan循环,例外非常重要.
结论:
- 尽管初始风险较高,心脏移植为ACHD患者提供了改善的长期生存率.
- 专门的ACHD中心对于管理这些复杂的患者至关重要.
- 仔细选择患者,风险减轻策略和适当的器官分配对于成功的结果至关重要.
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