HTK. Kaplan-Meier 65%

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1 Chin J Transplant Electronic Edition November 2014Vol. 8No ABO 5 UW HTK CT Kaplan-Meier Ⅰ ~ Ⅱ 9 65% % 36. 7% 30. 6% Evaluation of current combined heart-lung transplantation status in China and 10 years follow-up experience of a patient Yang ShouguoChen HaoYang ZhaohuaZhang HongqiangWang Fanshun Zhuang YaminWang Chunsheng. Department of Cardiothoracic SurgeryZhongshan Hospital of Fudan Universitythe Shanghai Institute of Cardiovascular DiseasesTransplantation Center of Fudan UniversityShanghai China Corresponding authorwang Chunsheng wang. chunsheng@ zs-hospital. sh. cn Abstract Objective To evaluate the cardiopulmonary allografts function on a heart-lung transplantation patient survived more than 10 years at Zhongshan Hospital and to summarize the status and results of current heart-lung transplantation in China. Methods A homologous heart-lung transplantation was performed on a femalediagnosed as Eisenmenger' s syndrome secondary to congenital atrial septal defect on December Heart-lung allograft was preserved with 1000 ml UW solution and 3000 ml HTK solution. Postoperative immunosuppressive therapies were managed with daclizumab + cyclosporine A + mycophenolate mofetil + corticosteroids. Cyclosporine A was transferred to tacrolimus at the 9th month and corticosteroids was withdrew at the 8th years postoperative. Prophylaxis against virus was managed with oral Valacicloviri for 3 months. Echocardiogrampulmonary DOI /cma. j. issn XD wang. chunsheng@ zs-hospital. sh. cn

2 Chin J Transplant Electronic Edition November 2014Vol. 8No function and thoracic CT were followed-up periodically. Literatures on clinical heart-lung transplantation between January 1992 and December 2013 in China were retrieved and analyzed attentively. Results The patient survived operation and experienced normal daily life during the follow-up of 10 years and 3 months. Echocardiogram showed left ventricular ejection fraction of 65%. Pulmonary function examination exhibited with signs of small airway obstruction. Howeverno severe acute allograft rejection episode was experienced. The patient was complicated with two episodes of pneumonia at the 5th week and 3. 5 years and both were cured. A total of 44 heart-lung transplantations were completed at 26 transplant centers in China mainland. Eisenmenger' s syndrome secondary to congenital heart diseases constituted most of the etiologies. The actuarial 1-yr3-yr5-yr survival rate was 39. 3% 36. 7% 30. 6% respectively. Infections and graft failure contributed to the main cause of death. Conclusion Excellent cardiopulmonary grafts preservationskilled operation technique carefully tailor immunosuppressive strategy and keep the balance of rejection and infection were key factors of long-term survival for heart-lung transplantation. Key words Heart-lung transplantation Long-term result Eisenmenger's syndrome ml 4 UW 3000 ml HTK min mg μg /L ~ 200 μg /L 9 8 ~ μg /L ppm E1 30 ng kg - 1 min Swan-Ganz 130 mmhg 1 mmhg = kpa Wood MasterScreen PFT Jaeger CT 28 ABO

3 Chin J Transplant Electronic Edition November 2014Vol. 8No CT SPSS13. 0 Kaplan-Meier Ⅰ ~ Ⅱ 1 1 a b. 7 CT c d. 9 CT 1 CT mm mm mm mmhg 1 1 d % ~ 94% CT mmhg = kpa L L FEF50% L /s FEF25% L /s % FEV1 /FVC FEF50%. 50% FEF25%. 25%

4 Chin J Transplant Electronic Edition November 2014Vol. 8No ~ % 63. 0% 50. 8% 3 17 ~ % 9. 5% 2 ~ % 2. 4% 2. 4% 4. 8% % % % 36. 7% 30. 6% 2 50% Kaplan-Meier CMV-IgM CMV

5 Chin J Transplant Electronic Edition November 2014Vol. 8No. 4 2 J 3 B J 4 J J J J HTK E J E E J J % E J J X CT J J J Yusen RDChristie JDEdwards LBet al. The registry of the International Society for Heart and Lung Transplantationthirtieth adult lung and heart-lung transplant report 2013focus themeage J. J Heart Lung Transplant J.. J J J J J J J.. J J J J

6 Chin J Transplant Electronic Edition November 2014Vol. 8No J J J J J J. J J J J J J. J J J s J J J J J J J J J J J J J J. J J J J J J J J J J J J LPD 77. J J E1 78. J. J h J Chiang CHWu KYu CPet al. Hypothermia and prostaglandin. 1 J. E1produce synergistic attenuation of ischemia-reperfusion lung J J J J C. 2009

7 Chin J Transplant Electronic Edition November 2014Vol. 8No. 4 injury J. Am J Respir Crit Care Med Takashima SKoukoulis GInokawa Het al. Inhaled nitric oxide reduces ischemia-reperfusion injury in rat lungs from non-heartbeating donors J. J Thorac Cardiovasc Surg Pabla RBuda AJFlynn DMet al. Nitric oxide attenuates neutrophil-mediated myocardial contractile dysfunction after ischemia and reperfusion J. Circ Res Cornfield DNMilla CEHaddad IYet al. Safety of inhaled nitric oxide after lung transplantation J. J Heart Lung Transplant Radovancevic BVrtovec BThomas CDet al. Nitric oxide versus prostaglandin E1 for reduction of pulmonary hypertension in heart transplant candidatesj. J Heart Lung Transplant J /CD