• Title/Summary/Keyword: 심장이식술

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Successful Heart Transplantation across an ABO Blood Group Barrier -One case report- (ABO 부적합성 심장이식술 -치험 1례 보고-)

  • 원태희;신윤철
    • Journal of Chest Surgery
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    • v.29 no.3
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    • pp.322-325
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    • 1996
  • ABO incompatible allografting is contraindicated in most organ transplantations including heart because of the hyperacute and acute rejections caused by preexisting antibodies. However several reports showed that ABO incompatible organ transplantation could be managed successfully by plasmapheresis, antibody adsorption, immunosuppression, splenectomy, and so on. We experienced one success in ABO incompatible cardiac transplantation by means of plasmapheresis and immunosuppression. However, this does not justify heart transplantation across ABO blood group barriers. Because the effect of ABO incompatibility on continued acute rejection or chronic rejection has not been fully understood, long-term follow-up study is required.

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Orthotopic Cardiac Transplantation after Inter-caval Anastomosis in a Patient with Hypertrophic Cardiomyopathy and Persistent Left Superior Vena Cava (지속성 좌상대정맥을 가진 비후성 심근증 환자에서의 양측상대정맥 문합술 후 심장이식술)

  • Joo, Seok;Kim, Gwan-Sic;Lim, Ju-Yong;Lee, Seung-Hyun;Cho, Won-Chul;Kim, Jae-Jung;Yun, Tae-Jin
    • Journal of Chest Surgery
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    • v.43 no.5
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    • pp.522-524
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    • 2010
  • Cardiac transplantation in a patient with persistent left superior vena cava (SVC) necessitates unifocalization of the caval veins. Here we report a successful case of orthotopic heart transplantation in a patient with hypertrophic cardiomyopathy and persistent left SVC. Cardiac transplantation was done after the left SVC was anastomosed to the right SVC in an end to side fashion. The postoperative course was uneventful, and the patient is currently in an excellent clinical condition.

A Case Report of Heart Transplantation Bridged by Bi-ventricular Assist Device in a Pediatric Patient of Prerenal Type ARF (소아환자에서 양심실 순환보조를 중개로 한 후 발생한 급성신부전 환자에서의 심장 이식수술 치험 1예)

  • Ra, Yong-Joon;Koak, Jae-Gun;Kim, Jin-Hyun;Oh, Se-Jin;Lee, Jae-Hang;Kim, Woong-Han
    • Journal of Chest Surgery
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    • v.39 no.11 s.268
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    • pp.854-857
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    • 2006
  • The patient was an eight-year-old female. She was diagnosed as dilated cardiomyopathy. She was supported with bi-ventricular assist because of heart failure for 15 days. After 7 days, she was suffered from prerenal type ARF and support with continuous veno-veno hemodyalisis(CVVHD). And then heart transplantation was performed, heart donor's blood type was A. Immune suppressants were used after due consideration for renal toxicity. ARF was resolved on post operative $14^{th}$ day. She was discharged on post operative $52^{nd}$ day without any specific post operative complication. She has been followed up without any immune rejection reaction upto 14 months.

Early Results of the Heart Transplantation for End Stage Heart Failure (말기 심부전증 환자에 대한 심장이식술의 조기 성적)

  • 노준량;원태희
    • Journal of Chest Surgery
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    • v.30 no.9
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    • pp.876-884
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    • 1997
  • Fourteen patients underwent orthotopic heart transplantation between March 1994 and May 1996 in Seoul National University Hospital. There were 9 male and 5 female patients, and the mean age was 40.8 $\pm$ 12.4 years ranged from 12 to 56 years. All patient were in NYHA Fc III or IV preoperatively. The underlying heart diseases were dilated cardiomyopathy in 11 and restrictive cardiomyopathy in 3. The mean age of donors was 24.9$\pm$ 10.2 years and the causes of the brain death were head trauma by traffic accidents in 8, subarachnoid hemorrhage in 2, 1 asphyxia, 1 fall down injury, 1 brain tumo , and 1 drowning, respectively The blood type was identical in 11, compatible in 2, and incompatible in 1 patient. The direct bicaval anastomosis technique was used in 11 cases, and standard right atrial anastomosis was done in the remaining 3 cases. The graft ischemic time was 158$\pm$44 minutes ranged 94 to 220 minutes. There were two hospital deaths(14.3%). The causes of deaths were 1 right ventricular failure followed by suspected cyclosporine induced hemolytic uremic syndrome and rejection, and 1 delayed massive bleeding, probably from rupture of the anastomotic pseudoaneurysm, respectively. The follow-up duration was 16$\pm$9 months(3 to 28 months). There was one late death(8.3%). All the other patients were in NYHA Fc I except one patient who was in hospital because of the acute rejection. The actuarial survival rates including hospital deaths were 93.7% at 1 month, 86.9% at 6 months, and 77$\pm$12% at 2 years. Conclusively, heart transplantation is the good strategy for the management of end stage heart disease with acceptable operative mortality and early follow-up results.

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Heart-Lung Transplantation in a Patient with VSD, PDA and Eisenmenger′s Syndrome (심실 중격 결손과 동맥관 개존증을 동반한 아이젠멩거 증후군 환자에서의 심장-폐이식 수술 -1예 보고-)

  • 홍유선;김도형;함석진;이교준;이두연;권혁문;김형중;조상호;백효채
    • Journal of Chest Surgery
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    • v.36 no.6
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    • pp.418-421
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    • 2003
  • Heart-lung transplantation is a widely accepted treatment for Eisenmenger'syndrome. The patient is a 41-years-old male diagnosed with Eisenmenger'syndrome due to patent ductus arteriosus. The pressures were checked as follows: aorta 130/80 mean 100 mmHg, pulmonary artery 130/80 mean 109 mmHg, and right ventricle 130/20 mmHg, right atrium mean 20 mmHg. The patient needed heart-lung transplantation due to enlarged right pulmonary artery (diameter 7.5 cm). The donor was a 24 years-old male diagnosed as brain death due to subdural hematoma. Ligation of patent ductus arteriosus was performed under the cardiopulmonary bypass followed by heart-lung transplantation. Patient was extubated on postoperative day one, transferred to the general ward on day 3, and was discharged on postoperative day 33. Cardiac and lung biopsy was performed on postoperative day 41 with no signs of rejection.