第1862期:New Heart Transplant Method Could Save More Patients

Researchers say a new method for heart transplants could increase the number of available organs and save more lives. Currently, most transplanted hearts come from donors who have been declared brain dead. This means the person no longer has signs of brain function after suffering a serious injury. In a brain death, machines can keep the body breathing and can provide oxygen to organs until they can be recovered and put on ice. But the new method would take hearts from medical cases known as circulatory deaths. These cases are also known as donation after circulatory death, or DCD. Circulatory deaths happen when a person has a nonsurvivable brain injury, but still has some brain function. In these cases, family members can decide to withdraw all life support measures. This means organs go without oxygen for a time before they can be recovered.

研究人员表示，一种新的心脏移植方法可以增加可用器官的数量并挽救更多生命。目前，大多数移植心脏来自已被宣布脑死亡的捐赠者。 这意味着该人在遭受严重伤害后不再有大脑功能的迹象。 在脑死亡中，机器可以让身体保持呼吸，并可以为器官提供氧气，直到它们被回收并置于冰上。但新方法将从被称为循环死亡的医疗案例中提取心脏。 这些病例也称为循环死亡后捐献或 DCD。当一个人的脑损伤无法存活，但仍有一些脑功能时，就会发生循环性死亡。 在这些情况下，家庭成员可以决定撤回所有生命支持措施。 这意味着器官在恢复之前会缺氧一段时间。

Currently, kidneys and some other organs are taken from people suffering circulatory deaths. But doctors have resisted using hearts because of possible organ damage from a lack of oxygen. A new study suggests that hearts might also be recoverable from cases of circulatory deaths. Researchers at North Carolina’s Duke University School of Medicine led the study, which was recently published in the New England Journal of Medicine. The researchers said using hearts from circulatory deaths could possibly give thousands more patients a chance at a lifesaving transplant. And it could increase the number of donor hearts by 30 percent. “Honestly if we could snap our fingers and just get people to use this, I think it probably would go up even more than that,” transplant doctor Jacob Schroder told The Associated Press. “This really should be standard of care,” he said.

目前，肾脏和其他一些器官是从患有循环死亡的人身上取出的。 但医生们拒绝使用心脏，因为缺氧可能会损害器官。一项新的研究表明，心脏也可能从循环死亡病例中恢复过来。 北卡罗来纳州杜克大学医学院的研究人员领导了这项研究，该研究最近发表在《新英格兰医学杂志》上。研究人员表示，使用循环系统死亡的心脏可能会让更多的患者有机会进行挽救生命的移植手术。 它可以使捐赠心脏的数量增加 30%。“老实说，如果我们能打响指让人们使用它，我认为它可能会涨得更多，”移植医生雅各布施罗德告诉美联社。 “这真的应该成为护理标准，”他说。

With the new method, doctors can remove hearts in circulatory deaths and put them in a machine that “reanimates” them. This process pumps blood and nutrients through the heart as they are being transported. The organs can also be tested to make sure they are effectively functioning before they are transplanted. The study involved multiple hospitals around the country, as well as 180 transplant patients. Half the patients received DCD hearts and half were given hearts from brain-dead donors that were transported on ice. Survival rates six months later were about the same – 94 percent for recipients of cardiac-death donations and 90 percent for those who got the usual hearts, the researchers reported. The findings are exciting and show the possibility “to increase fairness and equity in heart transplantation…” said Dr. Nancy Sweitzer. She is a heart transplant specialist at Washington University in St. Louis. Sweitzer, who was not part of the study, said she thinks the new method will permit more people with heart failure to receive lifesaving treatment.

使用这种新方法，医生可以在循环死亡中取出心脏，并将它们放入一台“复活”它们的机器中。 这个过程在输送血液和营养物质时将它们泵入心脏。 还可以对器官进行测试，以确保它们在移植前有效运作。该研究涉及全国多家医院，以及 180 名移植患者。 一半的患者接受了 DCD 心脏，另一半接受了冰上运输的脑死亡捐献者的心脏。研究人员报告说，六个月后的存活率大致相同——接受心脏死亡捐献的人为 94%，而接受普通心脏捐赠的人为 90%。Nancy Sweitzer 博士说，这些发现令人兴奋，并显示出“提高心脏移植的公平性和公平性……”的可能性。 她是圣路易斯华盛顿大学的心脏移植专家。 Sweitzer 没有参与这项研究，她说她认为这种新方法将使更多的心力衰竭患者接受挽救生命的治疗。

In the U.S. last year, 4,111 heart transplants were performed. While this was a record number, it is not nearly enough to meet the need. Hundreds of thousands of people suffer from advanced heart failure but many are never offered a transplant. Still others die waiting for one.

去年在美国，进行了 4,111 例心脏移植手术。 虽然这是一个创纪录的数字，但还远远不能满足需求。 数十万人患有晚期心力衰竭，但许多人从未接受过移植手术。 还有一些人死于等待。