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重症心不全に対する集学的治療 - jsao.org

49 .. Yoshiki SAWA.. 1.. New York Heart Association NYHA . 1967 Barnard peak VO2. 1980 cyclosporine CyA 14 ml/kg/min Heart Failure Survival Score . quality of life QOL 2 .. 1997 Lower-Shumway . 1 Bicaval anastomosis 1 . Bicaval anastomosis .. 2.. 1 .. 4 . cardioplegia .. 565-0871 2-2 . E-mail.. 41 1 2012 31. (a) (b). 2 . 1 . a Lower-Shumway b Bicaval anastomosis . 3 2 . 40 .. 3. 30 .. 2010 7 . CyA tacrolimus Tac mycophenolate . mofetil MMF prednisolone Pre 3 . mammalian target of rapamycin . mTOR 1999 1 30 . 24 . CyA Tac 6 25 . LVAD . 868 376 LVAD 552 412 .. primary graft dysfunction 6 . 2 IABP . PCPS . modified Euro-Collins Celsior .. mTOR . CNI . PTCA 3 CNI . CyA Tac . 1 CyA . 5 3 . 1 3 . 1 . CD20 . 2010 7 1 .. 32 41 1 2012 . 1 30 5 70 . 4 BSA . mTOR m2 . QOL . CD25 mTOR CNI Novacor LVAS . DCM . 2 VAD . 30 2 3 4 1 11 BTT . 1 11 3 6 . 70 80 . 22 LVAS . QOL .. LVAS .. / . LVAS . 4.. bridge to eligibility . 1970 3 VAD.

32 人工臓器41巻1号 2012年 本格的な移植医療が始まった(図2)。しかし,40年以上も 遅れて始まった我が国の移植医療は前途多難であり,今後,

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Transcription of 重症心不全に対する集学的治療 - jsao.org

1 49 .. Yoshiki SAWA.. 1.. New York Heart Association NYHA . 1967 Barnard peak VO2. 1980 cyclosporine CyA 14 ml/kg/min Heart Failure Survival Score . quality of life QOL 2 .. 1997 Lower-Shumway . 1 Bicaval anastomosis 1 . Bicaval anastomosis .. 2.. 1 .. 4 . cardioplegia .. 565-0871 2-2 . E-mail.. 41 1 2012 31. (a) (b). 2 . 1 . a Lower-Shumway b Bicaval anastomosis . 3 2 . 40 .. 3. 30 .. 2010 7 . CyA tacrolimus Tac mycophenolate . mofetil MMF prednisolone Pre 3 . mammalian target of rapamycin . mTOR 1999 1 30 . 24 . CyA Tac 6 25 . LVAD . 868 376 LVAD 552 412 .. primary graft dysfunction 6 . 2 IABP . PCPS . modified Euro-Collins Celsior .. mTOR . CNI . PTCA 3 CNI . CyA Tac . 1 CyA . 5 3 . 1 3 . 1 . CD20 . 2010 7 1 .. 32 41 1 2012 . 1 30 5 70 . 4 BSA . mTOR m2 . QOL . CD25 mTOR CNI Novacor LVAS . DCM . 2 VAD . 30 2 3 4 1 11 BTT . 1 11 3 6 . 70 80 . 22 LVAS . QOL .. LVAS .. / . LVAS . 4.. bridge to eligibility . 1970 3 VAD.

2 Destination therapy . 1980 . left ventricular LVAS . assist system; LVAS bridge to LVAS . transplantation; BTT LVAS MOF .. LVAS . bridge to recover y; BTR RVAS .. 1 VAD LVAS . paracorporeal pulsatile pump .. APTT . VAS 2 3 . LVAS . 20 kg PT-INR 3 .. implantable pulsatile VAS VAS . pump . 1 cm . ACE-I spironolactone .. Novacor . LVAS WorldHeart , Canada BTT 500 . 1,500 . 41 1 2012 33. (a) (b). 3 .. a b . QOL . LVAS .. Toyobo . 4 3 . 2011 4 2 EVAHEAR T . DuraHeart . 30 . 4 .. 5. 4 . 1 .. 2 . Menasch direct Genzyme needle injection . MAGIC Myoblast Autologous . Grafting in Ischemic Cardiomyopathy .. 24 97 . 3 . 5 3. 10 . Dib FDA in vitro 1 . Phase .. 4 .. BNP . 34 41 1 2012 . 5 . 1 .. Outflow Inflow . Percutaneous lead . Reserve power pack Compact 6 controller 2 6 .. HGF 2006 LVAS . VEGF LVAS .. 1 SDF-1 2007 3 1 . 5 . c-kit Sca-1 LVAS. girdling BNP 9 . effect LVAS 12 .. 3 .. 3 . 2006 7 LVAS viability . 3 . 1 6 2007 5 1.

3 55 2004 viablity . 41 1 2012 35. 7 Yamanaka group . 8 iPS . Yamanaka S et al, Cell, 2006. 8 iPS . 100 . 6. iPS . iPS. responder ES . iPS .. 7.. destination therapy . gap-junction . gap- . junction . 2007 11 Thomson . iPS 7 .. iPS . Cell . iPS .. iPS iPS . iPS . iPS . iPS iPS . teratoma .. 36 41 1 2012.