美国成人心脏移植现状与外科进展  

Current status and surgical advances in adult heart transplantation in the United States

作　　者：梁宏亮 LIANG Hongliang(Department of Cardiothoracic Surgery,Stanford University School of Medicine,Stanford,California,94305,USA)

机构地区：[1]Department of Cardiothoracic Surgery,Stanford University School of Medicine,Stanford,California,USA,94305

出　　处：《中国胸心血管外科临床杂志》2024年第11期1567-1588,共22页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：心脏移植是终末期心力衰竭患者最有效的治疗方式。近10年来,心脏移植外科领域取得了巨大进展,但供体心脏的严重不足始终是限制心脏移植广泛应用的关键问题。随着供心复苏、保存与评估技术的革新,扩展标准供体和循环死亡供体的应用日益增加,供心缺血的安全时限和获取地域范围不断扩大,均显著扩充了供体库,推动了心脏移植数量的迅速增长。同时,心脏移植外科技术和受体围手术期管理领域也涌现出许多新技术,特别是机械循环支持和人工智能的迅猛发展,有望为心脏移植领域带来革命性的变革。本文对近年来美国成人心脏移植的现状与外科主要进展进行综述和讨论,以期为读者提供启示,激发在该领域的持续探索与创新思路。Heart transplantation remains the most effective treatment for patients with end-stage heart failure.Over the past decade,significant advancements have been made in the field of heart transplant surgery.However,the enormous demand from heart failure patients and the severe shortage of available donor hearts continue to be major obstacles to the widespread application of heart transplantation.With the development of donor heart recovery,preservation,and evaluation techniques,the use of extended criteria donors and donation after circulatory death has increased.These technological advancements have expanded the safe ischemic time and geographic range for donor heart procurement,significantly enlarging the donor pool and driving a rapid increase in heart transplant cases.Concurrently,many new techniques have emerged in heart transplant surgery and perioperative management,particularly the rapid advancements in mechanical circulatory support and artificial intelligence,which hold the potential to revolutionize the field.This article reviews and discusses the current status and major surgical advancements in adult heart transplantation in the United States,aiming to provide insights and stimulate ongoing exploration and innovation in this field.

关 键 词：心脏移植 脑死亡后捐献供体 循环死亡后捐献供体 扩展标准供体 多器官联合移植 原发性移植物功能障碍 机械循环支持 人工智能 综述 

分 类 号：R654.2[医药卫生—外科学]