Objective To explore the related causes and management of the death cases (following) orthotopic heart transplantation (OHT). Methods The data of the death cases (14 cases) were studied retrospectively.Results Fourteen cases died among the total 54 cases of OHT from Aug. 1995 to Dec. 2004 in our hospital. Eight cases died within 1 month and 1 case subject to combined heart-kidney transplantation died on the 38th day, and the other 5 cases died during the period from 17 weeks to 4 years. The death cases died of acute right ventricular failure (4 cases), lung infection (5 cases, including 3 cases associated with fungus infection), acute rejection (4 cases), acute renal failure (4 cases), arrhythmia (4 cases), adult respiratory distress syndrome (2 cases) and diabetes (2 (cases)). The death of 8 cases was related with several causes.Conclusion Various causes should be (responsible) for the results. In order to decrease the mortality rate, the recipients should be selected with low pulmonary vascular resistance and less preoperative complications. It is very important to discover and manage complications in time perioperatively.

25?cm H 2O). Three of 6 d ead cases died of right heart failure after transplantation, whose PVR were more than 5 woods preoperatively. Twenty-two patients survived for 18 months with g ood quality of life.ConclusionAccurate selection for donor and recipient, suitable surgical procedure, excelle nt myocardial preservation, effective protection of recipient's renal function, early prevention and management of right graft-heart dysfunction can significa ntly decline incidence of right heart failure at postoperative early stage.

Objective To explore the experience of long-term outcomes of orthotopic heart transplantation. Methods From Aug. 1995 to Dec. 2004, 40 patients with end-stage dilatation cardiomyopathy, 36 males and 4 females, aged 13～60 years underwent orthotopic heart transplantation (OHT) , 39 standard styles and 1 total style. Results 40 cases were all successful treated. The survival time is from 8 to 112 months with heart function of 0-I degree. All cases are in good quality of live and enjoy normal entertainments and work. Pulmonary infection and cardiac arrhythmia are the most common complications but they did not degrade the result after proper treatments. Conclusion Heart transplantation is an effective treatment for patients with end-stage heart diseases. Appropriate selections of recipients with low pulmonary vascular resistance, satisfactory myocardial preservation are the key points to success. The precautions and prompt treatments to the postoperative complications are guarantee for the ultimate results of heart transplantations.

ObjectiveTo study the effect of implantation of the bone marrow cells into infarction myo cardium on the secretion of basic fibroblast growth factor (bFGF), insulin-like growth factor 1 (IGF-1), transforming growth factor-?1 (TGF-?1 ), interleu kin-1 (IL-1), and interleukin-8 (IL-8).MethodsBone marrow cells were implanted into the region of acute myocardial infarct via topical injection. Specimens were harvested at first, 2nd, 4th, 8th week after implantation for the expression of cytokines and vascular density examination by immunohistochemical analysis and the levels of cytokines by radioimmunoassay. ResultsAt first, 2nd, 4th, 8th week after transplantation, the vascular density in the bone marrow cell implant group was significantly higher than that in the control group (P

Objective: To study the effect of bone marrow cells on myocardial regeneration. Methods: Bone marrow cells were implanted into the acute myocardial infarct via topical injection. Specimens were harvested at 1st, 2nd, 4th, 8th weeks after bone marrow cells implantation for morphologic examination. Results: Bone marrow cells with fluorescence had been observed in the implanted site. A portion of the implanted cells had differentiated into myogenic cells. The regenerating myocardial cells observed by electron micrography had been connected with the host myocardium through intercalated discs. The infarct size was significantly smaller in implant group. Conclusion: This study suggested that bone marrow cells are capable to differentiate and regenerate into myocardial cells in the acute myocardial infarct sites and reduce size of infarct.

AIM and METHODS: To investigate the cardioprotective effect of adenosine infusion before ischemic preconditioning on immature myocardial reperfusion injury in rabbit heart. Isolated perfused working heart model were performed, all hearts were subjected to 2-hour global hypothermic ischemia and received intermittent cold cardioplegia perfusion. RESULTS:During reperfusion, the recovery of left ventricular systolic pressure, left ventricular end-diastolic pressure, +d p /d t max, and -d p /d t max of hearts received adenosine infusion before ischemic preconditioning were significantly improved, myocardial adenosine triphosphate and adenosine diphosphate content and superoxide dismutase activity were higher, the leakage of myocardial creatine kinase and the malondialdehyde content were lower, and myocardial water content was obviously less. CONCLUSION: These results suggest adenosine infusion before ischemic preconditioning enhances cardioprotection of ischemic preconditioning against immature myocardial reperfusion injury in the rabbit heart.

Kaneko's rahbit heart-lung transplant model was used xo investigate the effect of low flow perfusion(LFP)on rabbit heart-lung preservation.Thirty-two healthy rabbits were randomly divided into control group and experimental group.The donors in the experimental group were continuously perfused via aorta and pulmonary artery at low flow rate with the same perfusates during preservation.After heart-lung transplanted, the donors' LVsp, LVedp, RAP and Paw, and PaO2 were measured every 30 min for 90 min to evaluate the function of heart and lung.After finishing the trial, the contents of MDA in heart and lung were determined and the water weight gain calculated.The results showed that the rabbits in the experimental group had a significantly lower water weight gain and better cardiac and pulmonary function than in the control group.The experimental group produced less levels of MDA in heart and lung than did the control group.It is concluded that LFP is more effective than cold storage on rabbit heart-lung preservation.

Orthotopic heart transplantation was performed on two critical patients with end-stage dilated cardiomyopathy on Oct.14, 1996 and March 20, 1997 respectively.One case of pre-operative hepatic-renal failure died of systemic organs failure and severe circulation failure in oper-ation, and the other case of severe pulmonary hypertension preoperatively died of right heart fail-ure and pulmonary hypertension crisis on the seventh day after operation.Operating time and indi-cations of heart transplantation, preoperative evaluation for the patients with pulmonary hyperten-sion, and management of right heart failure after heart transplantation were detailedly discussed.

Orthotopic heart transplantation was successfully performed on one patients with endstage dilated cardiomyopathy.The patient has been survived for more than 1 year until today and is now living well.The immunosuppressive therapy and the acute rejective surveillance for 1 year after operation were detailedly introduced and discussed in this paper.In the second week and sixteenth week after operation,two episodes of acute cardiac rejection occurred and were promptly treated well with methylprednisolone.

Objective To investigate the protective effects of pulmonary surfactant (PS) in lung transplantation.Methods Forty-eight rabbits were divided into control group (group C),PS1 group,and PS2 group. Rabbit lungs were harvested and preserved at 4 ℃ for 6 h before transplantation. The PS1 group received 100 mg /kg of intratracheal PS before reperfusion,while the PS2 group received the same dosage PS before preservation. Using the hetero-heart-lung transplantation model,pulmonary graft function and airway compliance was assessed every 30 min for 3 h when the model was transformed into self-working state. After finishing the observation,the tissue specimens were taken for analysis of wet/dry ratio (W/D),the contents of malondialdehyde (MDA) and myeloperioxidase (MPO). All values were compared to the control group.Results The two groups treated with PS showed better airway compliance and higher PaO 2 and lower PaCO 2 than group C ( P