Cardiac Transplantation Under New Legislation for Organ Transplantation in Japan
- 1 January 2000
- journal article
- case report
- Published by Japanese Circulation Society in Japanese Circulation Journal
- Vol. 64 (5), 333-339
- https://doi.org/10.1253/jcj.64.333
Abstract
During the past 2 years since new legislation for organ transplantation from brain-dead donors came into effect in Japan, 3 cardiac transplants have been carried out, 2 of which were performed at the National Cardiovascular Center (NCVC). The recipient cases were 46- and 25-year-old male patients who suffered from end-stage dilated cardiomyopathy and had been listed for cardiac transplantation in the Japan Organ Transplantation Network as status I candidates. The first patient was supported by the use of a paracorporeal air-driven left ventricular assist device of the NCVC type, and had a moderate degree of renal and hepatic dysfunction at the time of transplantation. Donor hearts were transported from distant hospitals (Tokyo and Miyagi prefecture) and the transportation time was 1 h 33 min and 2 h 4 min, respectively. The operation was performed by the standard technique (Lower-Shumway) in the first patient and by the bicaval anastomosis technique in the second patient. Reperfusion of the transplanted heart was performed retrogradely through the coronary sinus utilizing leukocyte-depleted blood with a gradual increase in temperature. Total ischemic time was 3 h 34 min and 3 h 35 min, respectively. Weaning from the cardiopulmonary bypass was easy and uneventful in each patient. Immunosuppressive therapy was conducted with OKT-3 induction in the first patient because of the coexisting renal dysfunction and with a triple immunosuppressive regimen for both patients. Routine endomyocardial biopsy showed acute rejection of less than grade Ib, and the patients were discharged on the 65th and 46th postoperative day, respectively. At present, both patients are in the NYHA class I state and are ready to return to work. The uneventful recovery seen in these patients shows the advances made in transplant medicine, including the progress and improvement of immunosuppressive therapy, surgical techniques, myocardial protection, and detection and treatment of infection. Further efforts are required to fully establish the cardiac transplantation program in Japan.Keywords
This publication has 8 references indexed in Scilit:
- First brain dead donor heart transplantation under new legislation in Japan.The Japanese Journal of Thoracic and Cardiovascular Surgery, 1999
- Bicaval and standard techniques in orthotopic heart transplantation: Medium-term experience in cardiac performance and survivalThe Journal of Thoracic and Cardiovascular Surgery, 1999
- Monitoring of Human Cytomegalovirus Infections in Pediatric Bone Marrow Transplant Recipients by Nucleic Acid Sequence–Based AmplificationThe Journal of Infectious Diseases, 1998
- Clinical trial of retrograde warm blood reperfusion versus standard cold topical irrigation of transplanted heartsThe Annals of Thoracic Surgery, 1996
- Chronic mechanical circulatory support: Rehabilitation, low morbidity, and superior survivalThe Annals of Thoracic Surgery, 1994
- Total orthotopic heart transplantation: An alternative to the standard techniqueThe Annals of Thoracic Surgery, 1991
- Multi-Institutional Studies of the National Cardiovascular Center Ventricular Assist SystemAnnual Northeast Bioengineering Conference, 1989
- Homovital transplantation of the heartPlastic and Reconstructive Surgery, 1961