心肺联合移植1例术后8.5年随访报告.pdf

中南大学学报(医学版)2012,38(2)htp;/www.csumed.org;htp:/tbyx.xysmnet
J Cent South Univ(Med Sci)
CASE ANALYSIS
临床病例讨论?
DO1:10.3969/jiss.1672-7347.2013.02.018
心肺联合移植1例术后8.5年随访报告
尚宝朋,胡建国,周新民,张伟,廖晓波,李建明
(中南大学湘雅二医院胸心血管外科,长沙410011)
[摘要]对1例健康生存8.5年心肺移植患者进行总结分析。2003年9月20日湘雅二医院为1例室间隔缺损并重
度肺动脉高压的患者施行心肺联合移植术。分别采用1500mL改良St! Thomas心脏停搏液和3000mL改良LPD液保护
供体心肺。术后抗排斥反应,在诱导期使用甲泼尼龙+抗人淋巴细胞球蛋白治疗,稳定期采用环孢素A+骁悉+泼
尼松龙三联免疫治疗。至2007年改为骁悉500mg+FKS064mg,均毎天2次。定期复査超声心动图、FS06血药浓度。
随访时患者存活已超过8年。心功能恢复为(NYHA)IーI级,左心室射血分数61%-74%;提示心肺联合移植是治
疗心肺功能衰竭的有效方法,良好心肺保护、正确术后处理是心肺联合移植患者长期存活的关键。
[关键词]心肺移植;艾森曼格综合征;长期存活
8.5 year-follow-up of combined heart-lung
transplantation in a patient
SHANG Baopeng, HU Jianguo, ZHOU Xinmin, ZHANG Wei, LLAO Xiaobo, LI Jianming
( Department of Thoracic and Cardiovascular Surgery, Second Xiangya Hospital, Central South University, Changsha 410011, China)
ABSTRACT
To summarize the case of combined heart-lung transplantation for a patient who survived for 8.S years
20, 2003, at Second Xiangya Hospital of Central South Ur
lung transplantation was performed on a male patient who was diagnosed with cardiopulmonary failure
secondary to congenital ventricular septal defect with severe pulmonary hypertension. Heart-lung
allograft was preserved with 1500 mlmoifie St Thomas sotion an 3000 ml moie Pdsouton
Postoperative immunosuppressive therapies included: methylprednisolone and human anti-lymphocyte
P
th
A Cellc
in the stable period. In 2007, the treatment was changed to Cell Cept mg, twice a day+FK5064 mg, twice
a day. The patient lived 8.5
lal life with cardiac function of NYHA I-II. Echocardi
showed left ventricular ejection fraction of 61% to 74%. Heart-lung transplantation proved reliable
therapy modality for terminal cardiopulmonary failure. Excellent donor organ preservation and proper
perioperative treatment are key factors for long-term survival after heart-lung transplantation.
收稿日期( Date of reception):2012-03-31
作者简介( Biography):尚宝朋,硕土,主要从事心脏及大血管疾病研究。
通信作者(Correspondingauthor):李建明,Emal:lijiang.2004@)yahoo.com.cn