METHODS: In this follow-up study, we followed heart transplant recipients for 1 year to study patient survival, ejection fraction, adverse events, and organ rejection. We evaluated follow-up results on time from brainstem death test to the cross-clamp placement, as well as the type of inotrope used.
RESULTS: Our study enrolled 54 heart transplant candidates. The inotrope dose was 3.66 ± 0.99 μg/kg/min, and the most used inotrope, with 28 cases (51.9%), was related to dopamine. Six cases (11.1%) of death and 1 case of infection after transplant were observed in recipients. The average ejection fraction of transplanted hearts before transplant, instantly at time of transplant, and 1 month, 6 months, and 1 year after transplant was 54.9 ± 0.68, 52.9 ± 10.4, 51.9 ± 10.7, 50.1 ± 10.9, and 46.8 ± 17, respectively; this decreasing trend over time was significant (P =.001). Furthermore, ejection fraction changes following transplant did not differ significantly in transplanted hearts regarding brain death interval and type of inotrope used.
CONCLUSIONS: Our study revealed that cardiac output of a transplanted heart may decrease over time and the time elapsed from brain death, and both dopamine and norepinephrine could have negligible effects on cardiac function.
方法:在这项后续研究中,我们追踪心脏移植受者1年来研究患者的生存率,射血分数,不良事件,和器官排斥。我们评估了从脑干死亡测试到交叉钳放置的时间的随访结果,以及使用的inotrope的类型。
结果:我们的研究招募了54名心脏移植候选人。Inotrope剂量为3.66±0.99μg/kg/min,和最常用的Inotrope,28例(51.9%),与多巴胺有关.受者移植后死亡6例(11.1%),感染1例。移植前心脏的平均射血分数,在移植时立即,1个月,6个月,移植后1年分别为54.9±0.68、52.9±10.4、51.9±10.7、50.1±10.9和46.8±17;这种随时间的下降趋势是显著的(P=.001)。此外,移植后的射血分数变化在脑死亡间隔和使用的Inotrope类型方面在移植心脏中没有显着差异。
结论:我们的研究表明,移植心脏的心输出量可能会随着时间和脑死亡时间的推移而减少,多巴胺和去甲肾上腺素对心脏功能的影响可以忽略不计。