vtioВестник трансплантологии и искусственных органовRussian Journal of Transplantology and Artificial Organs1995-1191Academician V.I.Shumakov National Medical Research Center of Transplantology and Artificial Organs", Ministry of Health of the Russian Federation10.15825/1995-1191-2019-1-7-16vtio-984Research ArticleКлиническая трансплантологияClinical TransplantologyТрансплантация донорского сердца с гипертрофией миокарда левого желудочка 1,5 см и болееTransplantation of cardiac allografts with left ventricular hypertrophy 1.5 cm and moreПопцовВ. Н.PoptsovV. N.

123182, Москва, ул. Щукинская, д. 1.Тел. (963) 644-96-39.

1, Shchukinskaya str., Moscow.  Tel. (963) 644-96-39.

poptsov_vit@mail.ruСпиринаЕ. А.SpirinaE. A.

Москва

Moscow

УстинС. Ю.UstinS. Yu.

Москва

Moscow

МасютинС. А.MasutinS. A.

Москва

Moscow

ДогнашеваА. А.DogonachevaA. A.

Москва

Moscow

ВоронковВ. Ю.VoronkovV. Yu.

Москва

Moscow

ЗолотоваЕ. Н.ZolotovaE. N.

Москва

Moscow

СкоковаА. И.SkokovaA. I.

Москва

Moscow

ФГБУ «Национальный медицинский исследовательский центр трансплантологии и искусственных органов имени академика В.И. Шумакова» Минздрава РоссииРоссияV.I. Shumakov National Medical Research Center of Transplantology and Artificial Organs of the Ministry of Healthcare of the Russian FederationRussian Federation201916052019211716Copyright © Попцов В.Н., Спирина Е.А., Устин С.Ю., Масютин С.А., Догнашева А.А., Воронков В.Ю., Золотова Е.Н., Скокова А.И., 20192019Попцов В.Н., Спирина Е.А., Устин С.Ю., Масютин С.А., Догнашева А.А., Воронков В.Ю., Золотова Е.Н., Скокова А.И.Poptsov V.N., Spirina E.A., Ustin S.Y., Masutin S.A., Dogonacheva A.A., Voronkov V.Y., Zolotova E.N., Skokova A.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.transpl.ru/vtio/article/view/984

Недостаточное количество донорских органов делает допустимым трансплантацию сердца от доноров с расширенными критериями, в том числе с гипертрофией миокарда левого желудочка.

Цель исследования

Цель исследования: обосновать эффективность выполнения трансплантации сердца от доноров с гипертрофией миокарда левого желудочка.

Материалы и методы

Материалы и методы. В исследование включены 160 реципиентов сердца, которым выполнили трансплантацию сердца (ТС) от доноров с гипертрофией миокарда левого желудочка (ГМЛЖ) 1,5 см и более в период с 2011-го по 2017 г.

Результаты

Результаты. Продолжительность анестезиологического пособия при ТС с ГЛЖ 1,5 cм и более составила 6,5 ± 0,7 ч, оперативного вмешательства – 4,7 ± 0,3 ч, искусственного кровообращения (ИК) – 63–290 (145 ± 47) мин, ишемии сердечного трансплантата – 86–426 (168 ± 44) мин. Продолжительность лечения в ОРИТ составила 7,4 ± 8,5 суток. Госпитальная летальность при ТС с гипертрофией левого желудочка 1,5 см и более составила 8,1% (n = 13). 30-дневная выживаемость реципиентов после ТС составила (n = 147) 91,9%. При сравнительном анализе не выявили достоверного различия ранней и отдаленной выживаемости реципиентов, которым ТС была выполнена от доноров с гипертрофией левого желудочка более 1,5 см и от доноров без гипертрофии левого желудочка (p = 0,659).

Заключение

Заключение. Накопленный опыт демонстрирует удовлетворительные показатели ранней и отдаленной выживаемости у реципиентов исследуемой группы. В большинстве случаев сократительная функция левого желудочка нормализуется в ранние сроки после ТС.

Introduction

Introduction. In case of donor heart shortage and expanding pool of patients waiting for heart transplantation (OHTx) liberalization of donor selection, especially use of donors with left ventricular hypertrophy (LVH), may be one of most realistic methods to extending number of OHTx.

Aim

Aim: to evaluate early and late outcomes after OHTx from donors with LVH ≥1.5 cm.

Methods

Methods. We reviewed 160 heart recipients who underwent OHTx from donors with LVH 1.5 cm or more from 2011 to 2017.

Results

Results. The duration of anesthesia was 6.5 ± 0.7 h, surgery – 4.7 ± 0.3 h, cardiopulmonary bypass – 63–290 (145 ± 47) min and ischemia time was – 86–426 (168 ± 44) min. ICU stay was 7.4 ± 8.5 days. Hospital mortality in the study group was 8,1% (n = 13) and 30-day survival was 91.9%. Patients with or without donor LVH had similar early and long-term survival (p = 0.659).

Conclusions

Conclusions. Own experience demonstrates the satisfactory results of HT from donors with LVH. In more cases, LV systolic function of cardiac allograft quickly normalized in the early period after HT.

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The authors declare that there are no conflicts of interest present.