中国体外生命支持2026，Vol.24Issue(1)：8-12,5.DOI:10.13498/j.cnki.chin.j.ecls.2026.01.02
心脏移植围术期临床结果及院内死亡危险因素分析:一项单中心回顾性研究
Perioperative Clinical Outcome and Related Risk Factors After Heart Transplantation Surgery:a Single-Center Retro-spective Study
摘要
Abstract
Objective Heart transplantation is an effective treatment for patients with end-stage heart failure.This article mainly explores perioperative clinical outcomes after heart transplantation and the risk factors related to postoperative mortality.Methods A retrospective analysis was conducted on the clinical data of patients who underwent heart transplantation in the Department of Cardiovascular Surgery,the First Affiliated Hospital of Naval Medical University from January 2018 to January 2024.Patients were divided into survival and non-survival groups based on in-hospital mortality.Preoperative characteristics,intraoperative data,and postoperative outcomes were compared between the two groups,and multivariate Firth logistic regression was used to analyze the risk factors related to early in-hospital death after surgery.Results A total of 170 patients were included in this study,including 132 males(77.65%).The main preoperative disease etiology was dilated cardiomyopathy(80.58%).There were 23 in-hospital deaths,yielding an early mortality rate of 13.5%.The causes of death included 10 cases of graft dysfunction,9 cases of multiple organ dysfunction,and 4 cases of sepsis.Compared with the survival group,the non-survival group had significantly lower preoperative platelet count and higher preoperative pulmonary artery pressure.No statistically significant differences were observed in intraoperative parameters between the groups.Analysis of postoperative outcomes showed that the non-survival group had a significantly higher rate of receiving mechanical circulatory support(including IABP,ECMO,ECMO+IABP)(35%vs.9.5%,P=0.003),and a higher incidence of pulmonary infection(21.7%vs.3.4%,P=0.005).Multivariate Firth regression analysis found that elevated preoperative mean pulmonary artery pressure was an independent risk factor for in-hospital death after heart transplantation.Conclusion The perioperative mortality rate of heart transplantation remains relatively high.High preoperative pulmonary artery pressure is an independent risk factor for early in-hospital mortality after heart transplantation.关键词
心脏移植/临床结果/危险因素/平均肺动脉压/主动脉内球囊反搏/体外膜氧合Key words
heart transplantation/clinical outcome/risk factor/mean pulmonary artery pressure/intra-aortic balloon pump/extracorporeal membrane oxygenation引用本文复制引用
周炜,刘晓彬,杜珍,徐志云,韩林,朱峰,李白翎..心脏移植围术期临床结果及院内死亡危险因素分析:一项单中心回顾性研究[J].中国体外生命支持,2026,24(1):8-12,5.基金项目
国家重点研发计划项目(2024YFC3505700) （2024YFC3505700）
海军军医大学新技术培育项目(ZJXS2024B16) （ZJXS2024B16）
