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Herztransplantation

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Die erstmals 1967 am Menschen vorgenommene orthotope Herztransplantation hat sich mittlerweile zu einem etablierten Behandlungskonzept entwickelt. Der Bedarf an Herztransplantationen übersteigt die Verfügbarkeit an Spenderorganen. Die Einjahresüberlebensrate liegt bei 80–85%, die Fünfjahresüberlebensrate bei 65–75%, und nach 10 Jahren leben noch 45–55% der herztransplantierten Patienten. Herztransplantierte, deren Spender jünger als 40 Jahre sind, überleben länger [54]. Als klassische Indikation für eine Herztransplantation gilt die therapierefraktäre Herzinsuffizienz (NYHA IV). Ein bedeutsamer funktioneller Parameter ist die maximale Sauerstoffaufnahme; eine VO2max < 12 ml/min · kg dient als zusätzliches Kriterium für eine Herztransplantation [10]. Im ersten Jahr nach Transplantation sind akute Abstoßungsreaktionen und Infektionen die häufigsten Todesursachen. Weitere, meist längerfristige Komplikationen und Probleme sind Neoplasien und das Auftreten einer Transplantatvaskulopathie sowie Hypertonie, Niereninsuffizienz, Kortikoidmyopathie, Hyperlipoproteinämie und Osteoporose.

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Copyright information

© Steinkopff Verlag Darmstadt 2007

Authors and Affiliations

  1. 1.Institut für Sport- und PräventivmedizinUniversität des SaarlandesSaarbrücken

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