ABSTRACT
Objective:To retrospectively analyze the experience of our center in the use of marginal donor heart, and to explore the principle of use and risk control of marginal donor heart.Methods:A total of 31 patients with end-stage heart disease underwent orthotopic heart transplantation in our center from January 2018 to December 2018, including 28 cases of pure heart transplantation, 2 cases of combined heart-lung transplantation, and 1 case of combined heart-kidney transplantation. 26 of the 31 cases were marginal donor hearts. These patients were all anastomosed by a double lumen method.Results:The rates of postoperative use of ECMO, IABP and acute rejection were zero in this study. The time of cardiopulmonary bypass in the marginal donor group was significantly longer compared with the conventional donor group( P<0.05), but there was no significant difference between the two groups in terms of hospitalization time, mechanical ventilation time, ICU stay time, abnormal rate of ECG, LVEF and blood biochemical indexes(all P>0.05). The postoperative follow-up rate was 100% in the two groups. One case of combined heart-lung transplantation in the marginal donor group died of multiple organ failure in the first month after surgery. During the postoperative follow-up period, the incidence of moderate to severe tricuspid regurgitation and the incidence of recurrent heart failure were zero in the two groups. There was no significant difference in the incidence of arrhythmia, LVEF, infection and blood biochemical parameters. Conclusion:The application of marginal donor heart has no significant effect on the short-term survival rate and recovery of patients after heart transplantation, but the long-term effect needs further follow-up.
ABSTRACT
BACKGROUND: To determine the yet unknown relation between thoracic aortic dissection (TAD) and sympathetic nervous system activity. METHODS: Variables such as electrocardiography, blood pressure, respiratory activity, postganglionic muscle sympathetic nerve activity (MSNA), plasma norepinephrine, tyrosine hydroxylase-positive nerve fiber density, and growth-associated protein 43-positive nerve fiber density were detected and statistically analyzed. RESULTS: TAD Patients showed a significant lower R-R interval variance and higher blood pressure, heart rate, respiratory rate, MSNA, plasma norepinephrine (reflecting elevated sympathetic nervous system [SNS] activity), higher tyrosine hydroxylase, growth-associated protein 43-positive nerve fiber density (reflecting sympathetic sprouting and innervation) than those of the control group. CONCLUSIONS: In TAD patients, both overall and regional aortic SNS activities are elevated.
