Abstract:

Objective To conclude the selection and management of brain death organ donor and the effect of cardiac transplantation on single central. Methods 110 cases heart failure patients received orthotopic heart transplantation from single central between January 2014 and June 2016. There were 86 male patients and 24 female patients. The average age was（34.5±12.7）years old，the average body mass was（52.7±14.9）kg. Therewere 84 cases diagnosed as dilated cardiomyopathy，4 cases as serious valve disease，22 case of serious ischemiccardiomyopathy. The heart function of all patients was grade NYHA Ⅲ or Ⅳ . The preoperative echocardiography showed left ventricular end-diastolediameter was（72±9）mm，the left ventricular ejection fraction was 12%-35%，the artery pulmonary pressure was 30-78 mmHg（1 mmHg ＝ 0.133 kPa），total pulmonary resist pressure was less than 48 kPa·s/L. The donors age were 21-45 years old without any cardiovascular disease or other diseases history of other major organs. The ischemic time of the donor hearts were（165±18）mins. The mean aortic clamp time was（72±18）mins. Cyclosporine A，MMF and prednisone were used as anti-immune response strategy. Results Postoperative complications included 9 cases of right heart failure，13 renal dysfunctionand 6 cases acute immune rejection. Totally 8 patients died in the perioperative period，in which 3 cases of heart dysfunction，2 case of serious infection and 3 cases of multiple organ failure. Conclusion The restrict brain death donors selection and management is the key point of success of heart transplantation，due to the serious changes in the nervous system and endocrine system of brain death donor.