The blood flow is not interrupted, and the heart is beating! The world's first "non-ischemic" heart transplantation was completed in Guangzhou
China News Service, Guangzhou, July 16 (Cai Minjie, Liang Jiayun, Lin Zhiwei) The First Affiliated Hospital of Sun Yat-Sen University announced on the 16th that the world's first "non-ischemic" heart transplant was successful.
This is the first time that the hospital's "non-ischemic" organ transplantation technology has been applied to the field of heart transplantation after liver transplantation and kidney transplantation.
The heart is the source of life's power. Once the heart stops beating, it means the death of life.
For patients with heart failure, heart transplantation technology brings hope to them.
In the process of traditional transplantation, the heart must be isolated, arrested, and refrigerated. Myocardial ischemia is inevitable. Myocardial ischemia is the most important factor affecting the patient’s prognosis. It can lead to postoperative cardiac insufficiency and cardiac insufficiency. Serious consequences such as no function or even death of the patient.
According to He Xiaoshun, deputy dean of Zhongshan First Hospital and leader of the Department of Organ Transplantation Science, since the heart is the most sensitive organ to ischemic damage, if the isolated ischemic time exceeds 6 hours, the risk of surgery will increase significantly.
How to solve the problem of ischemic damage during heart transplantation has always been a key research direction of scientists around the world.
The multi-disciplinary team of the hospital formed a joint research team. After more than two years of exploration, a new set of heart transplantation technology procedures was finally explored, and the technology was named "Ischemia-free Heart Transplantation".
In order to ensure a safe transition from the experimental stage to the clinical application, the team also completed more than 10 clinical "non-ischemic" heart acquisition and isolated normal temperature mechanical perfusion exercises.
On May 24, 67-year-old Fubo was diagnosed as "dilated cardiomyopathy" when he was seen in Zhongshan No. 1 Hospital. The results of cardiac MRI, echocardiography, and blood tests all indicated that Fubo's heart has entered the terminal stage. The most important source of power-the systolic function of the left ventricle has been reduced to one-fourth of the normal level. At the same time, he also suffers from basic diseases such as hypertension, arteriosclerosis, pulmonary hypertension, and decreased renal function.
After MDT consultations in more than 10 specialties including heart surgery, cardiology, organ transplantation, etc., experts agreed that, except for heart transplantation, other conventional surgical treatments could no longer solve Fauber's heart problems.
In addition, because Fober suffers from severe cardiomyopathy, heart failure, and moderate or higher pulmonary hypertension, if traditional heart transplantation is performed, the risk is also great.
Forber's heart and various organ functions have recovered smoothly.
Photo courtesy of the First Affiliated Hospital of Sun Yat-sen University
At 14:00 on June 26, Forber and the recipient donor entered the operating room at the same time.
More than 40 medical staff have been involved in an unprecedented "heart-changing battle".
As the surgeon quickly and neatly placed the tube and blocked it, the extracorporeal donor heart perfusion started to work. The donor heart freed from the pericardial cavity was beating vigorously in the organ groove without stopping, and remained normal. The body temperature is transferred to the recipient's operating room.
The expert puts on special gloves and carefully transfers the beating donor heart from the transfer slot to Forber's pericardial cavity.
The "non-ischemic" heart transplant operation lasted 4.5 hours, realizing the transplantation of the donor's heart to the recipient without interrupting the blood supply and "stopping".
Forber returned to the extracardiothoracic ICU after surgery, and the tracheal intubation was removed 36 hours after the operation. The echocardiogram showed that the cardiac ejection fraction increased from 16% before the operation to 78%, and the heart and various organ functions have recovered smoothly. , May be discharged from the hospital in the near future.
At the world’s first “ischemic-free” heart transplant press conference, Stefan Tullius, Director of Transplant Surgery and Research Director of Transplant Surgery at Brigham and Women’s Hospital and Professor of Surgery at Harvard Medical School, said through a video that this is a milestone in organ transplantation. Improve the quality of organs and provide a basis for further research on the effects of ischemia and reperfusion injury on transplant immunity.
Bjo?rn Nashan, the former president of the European Transplantation Association, commented: "The operation further proves the feasibility of heart transplantation without ischemia, and at the same time, it may significantly reduce the risk of transplanted cardiovascular disease in patients, and help improve the patient’s post-transplantation Survival rate."
The application of the “non-ischemic heart transplantation” means that the “marginal donor” that was previously predicted to be unusable can help more end-stage heart disease patients and enable heart donors in the donor assessment stage Improve the efficacy of heart transplantation in advance.
At present, the creation of "no ischemia" heart transplantation technology, "no ischemia" liver transplantation, and kidney transplantation technologies together constitute the "no ischemia" organ transplantation technology system, bringing the development of organ transplantation into a new era.
Nancy Ascher, president of the World Transplant Association, said that "non-ischemic" organ transplantation can be expanded to the heart, lung, and kidney transplantation fields, and can be promoted to other regions around the world. It has broad application prospects.
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