Expert: Princess Diana Could Have Been Saved
(London) The Sunday Telegraph pointed out that Dr. Christian Barnard, who performed the world’s first heart transplant, said in his forthcoming book that Princess Di would have had a chance to live if she had been taken to hospital immediately within 10 minutes of the crash.
Patient: A patient with dilated cardiomyopathy from Huangshi received a heart transplant at Concord Hospital on September 26, 2004, and everything is going well. Before this, he had been given several critical illness notices by the hospital and was completely dependent on medication to keep him alive. The patient himself feels that life and death are two different things. Which feels different, Mo kind of say is not too much. Wuhan Union Hospital Cardiac Surgery Department Xia Jiahong
Heart for heart, heart for heart
With the increasing incidence of cardiovascular disease, human research on the treatment of cardiovascular disease has also continued to deepen, the level of medical and surgical treatment has been able to solve most of the disease, however, about 10% of patients with conventional treatment is not good, then there is only one way to Huashan —– heart transplant.
The heart transplant is commonly referred to as the removal of the patient’s own ungodly heart, and then the healthy heart is put in. The operation itself is quite simple, just like a connection between the inlet and outlet pipes, the good heart and their own arteries and veins will be connected together.
Heart-for-heart is easier said than done. Human heart transplantation has been researched and developed for decades, but it is only in the past decade or so that it has been applied to clinical practice and has achieved long-term survival. However, the outcome of successful heart transplant patients after surgery is very good, the patient is like a normal person, a hundred things can be done, that is really heart to heart, good.
Heart transplantation is good, mating is the key
As mentioned earlier, heart transplantation is good, but it is difficult to do after the surgery. The reason for this is rejection. Once someone else’s heart is put in, other tissues and organs of the body will try to kill the heart and reject it, which is called rejection. This is called rejection. If the rejection is not handled properly, the transplant surgery is done for nothing.
The first hurdle in solving rejection is to get a good match. Simply put, it is to find a heart that is quite similar to your own, so that your other tissues and organs are not distinguishable as much as possible. The classical view is that the blood type is compatible, the lymphotoxicity test is negative, and the histocompatibility antigen sites are close, preferably the more identical the better. Of course, an identical heart match is almost impossible, especially with the current difficulties in sourcing donors, and it would be nice to find a 25% identity. The rest of the work is left to the anti-rejection drugs to control the reaction.
Pediatric heart transplantation a savior for children with severe heart disease
Advances in heart transplantation technology in recent decades, as well as the development of related disciplines, have led to an increasing number of children with complex heart disease receiving heart transplants and consequently being given a new lease on life. With five-year survival rates for newborns reaching 80% in some of the leading heart transplant centers, heart transplantation has become a lifesaver for children with severe heart disease.
An important prerequisite for a successful heart transplant is that the blood type of the donor and recipient be compatible. In Europe and the United States, blood types are mostly “O”, but even so, the limited number of “O” donor hearts is still not enough to meet the needs of many children. And once the rare “A” or “AB” blood type heart donor is available, it is often wasted due to blood type incompatibility. The main difficulty with infant heart transplantation is the lack of suitable donors, and many children leave this colorful world prematurely because they cannot find a donor.
Organ transplantation between a donor and a recipient with ABO blood group system incompatibility has always been a contraindication to heart transplantation because the immune system of the recipient (i.e., the host) produces a series of immune reactions to the donor blood group antigens present in the graft, which is called hyperacute immune rejection because it occurs within a relatively short period of time after the host receives the graft.
The neonatal immune system is not yet mature, and higher levels of blood group antibodies are not produced until 12-14 months of age. Also, during this time, the infant lacks the levels of complement (a molecule involved in the immune response) needed to trigger hyperacute immune rejection. Therefore, heart transplantation between blood-mismatched donors-recipients is feasible in early infancy.
The possibility of transplanting hearts between blood-mismatched donors and recipients was recently investigated by a Canadian research group. They compared the incidence of hyperacute graft rejection in children with heart disease after receiving an ABO-compatible heart or an incompatible heart transplant. The 20 infants, all with congenital heart disease, were born between 4 hours and 14 months of age, and 10 of them received ABO blood type-matched donor heart transplants, while the remaining 10 received ABO blood type-inappropriate heart transplants. As a result, 80% of the children with congenital heart disease survived the transplantation, except for two children who died early for other reasons. The follow-up period ranged from 11 months to 4.6 years, during which no hyperacute rejection was observed, and no diseases related to blood group incompatibility were detected. It appears that heart transplantation in infants with ABO blood group incompatibility is safe as long as it is performed early in the infant’s life, before the development of blood group antibodies.
In the face of limited donor hearts, how much hope and relief this study can bring to children with heart disease and their parents who are anxiously waiting for a suitable donor heart!
Heart transplantation, it’s not easy to say I love you
Although heart transplantation has become a routine treatment and the last line of defense for patients with critical heart disease, there are various reasons that limit the widespread use of heart transplantation.
There are limited sources of donor hearts. Even in countries where laws have been passed, there are large numbers of patients waiting in line for a heart that looks like theirs to extend their lives. Often, patients cannot wait for this day to arrive and pass away. In countries where there is no law, the only way is through donation by a blood relative. There are two kidneys, so it doesn’t matter if you donate one, but there is only one heart. The difficulty is imaginable.
The preservation time of the donor heart is limited. With existing means of preservation, a living heart can only remain transplantable and healthy for four to six hours, leaving more than 10,000 patients in need of heart transplants worldwide each year to die in desperate waiting because the donated living heart has become inactive during transport. Happily, scientists at the University of Pittsburgh’s Organ Donation Institute announced through a press release that they have invented a new device for preserving living hearts. This device allows the living heart to continue beating and remain effectively active for up to 12 hours after leaving the body. This preservation time is a full six hours longer than the current limit of preservation time. These six hours, which are insignificant to a normal person, can mean hope for a patient on the operating table waiting for a donor heart. The new preservation method, called Portable Organ Preservation System (POPS), reportedly works by placing the donated living heart in a simulated human environment. Fresh blood, oxygen flows through the heart’s vessels and ventricles as usual, allowing it to continue to contract and beat under simulated conditions, thus keeping it active.
Costly. Even in countries with excellent health insurance systems, such as the United States, heart transplants are high cost. In countries like China, heart transplants are prohibitive for the majority of patients. Not only does the surgery cost 100,000 won, but the cost of anti-rejection medication, which costs thousands of won per month after the surgery, is also quite scary. Of course, with the continuous development of social economy and culture, and the continuous improvement of various laws and systems, heart transplantation will definitely become a popular treatment for the general public.
Funny one.
Johnson mocked his Republican political opponents by saying.
”There’s an old man who needs a heart transplant. There are three hearts to choose from: one for an 18-year-old athlete, a second for a 19-year-old dancer, and a third for a 75-year-old banker. This patient asked the banker about his political views and learned that he was a Republican. Knowing this, this patient chose the banker’s heart.
”The transplant was quite successful. People asked him why he preferred the heart of a 75-year-old man over a vibrant young man’s heart, and he said, ‘I needed a heart that I knew had never been used.'”