How does heart transplant surgery work? - Roni Shanoada

2,282,159 views

2022-05-24・ TED-Ed

How does heart transplant surgery work? - Roni Shanoada

2,282,159 views・2022-05-24

TED-Ed


Please double-click on the English subtitles below to play the video.

翻译人员: Yan Li Xiao 校对人员: Yuwei Wu
00:07
Your heart beats more than 100,000 times a day.
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你的心脏每天跳动 超过 100,000 次。
00:11
In just a minute, it pumps over five liters of blood throughout your body.
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在短短一分钟内,它就促使五升以上 的血液泵入你的全身。
00:17
But unlike skin and bones, the heart has a limited ability to repair itself.
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但与皮肤和骨骼不同的是,心脏 的自我修复能力有限。
00:22
So if this organ is severely damaged,
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所以如果这个器官严重受损,
00:25
there’s often only one medical solution: replacing it.
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它通常只有一种医疗解决方案: 更换它。
00:30
Today, nearly 3,500 heart transplants are performed each year
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如今,每年执行 近 3,500 例心脏移植,
00:35
in a complex and intricate procedure with no room for error.
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在错综复杂的过程中, 没有犯错的余地。
00:40
The process begins by testing potential recipients
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首先要测试潜在的接受者
00:44
to ensure they’re healthy enough for this demanding operation.
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以确保他们足够健康来接受 这种艰难的手术。
00:49
Doctors are especially concerned with identifying immunocompromising illnesses
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医生特别关心 识别免疫功能低下的疾病
00:54
or any other conditions that could compromise a patient's chance of survival.
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或任何其他可能 危及患者的生存机会的状况。
00:59
The next step is to match an eligible recipient with a heart donor.
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下一步是匹配符合条件的 心脏捐赠者的接受者。
01:04
Donors are often comatose patients with no chance of being resuscitated
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捐赠者通常是没有 复活的机会的昏迷患者
01:09
or victims of a fatal event whose hearts are still healthy.
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或心脏仍然健康的 致命事件受害者。
01:14
In both cases, these patients need to be registered as an organ donor
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在这两种情况下,这些患者都需要 登记为器官捐献者,
01:18
or have their families give consent.
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或让他们的家人同意。
01:21
And even when a heart is available,
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即使有一颗心脏,
01:23
surgeons can’t just pair any donor with any recipient.
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外科医生不能直接配对 任何捐赠者和任何接受者。
01:27
The recipient’s immune system will view a transplanted heart
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接受者的免疫系统将会把 移植的心脏看作为
01:31
as a foreign organism that must be attacked.
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必须受到攻击的外来生物。
01:35
So doctors need to match recipients with donors that share their blood type
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所以医生需要匹配接受者 给跟他们有一样血型
01:40
and have similar antigens.
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并具有相似抗原的捐赠者。
01:42
If a match can be made, the surgery can begin.
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如果可以匹配, 手术就可以开始。
01:45
Once the donor's heart is confirmed to be healthy,
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一旦捐赠者的心脏 被确认是健康的,
01:49
the organ is immersed in an ice slush
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该器官会被浸入冰泥中
01:51
and injected with a solution to induce cardiac arrest.
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并被注入可以促使 心脏骤停的溶液。
01:56
These treatments stop the heart from pumping
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这些治疗使心脏停止跳动
01:58
to ensure it can be removed cleanly.
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以确保它可以被 干净利落地移除。
02:01
Surgeons then place the organ in a mix of cold saline
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然后外科医生将放置器官
02:05
and preservation solution.
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在冷盐水和保存 溶液的混合物中。
02:08
This is when the clock starts.
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这是时间开始的时候。
02:10
Disconnected from its blood supply,
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与它的血液供应断开,
02:12
the heart’s cells start taking on damage from lack of oxygen.
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心脏细胞开始由于缺氧,受到损伤。
02:16
The organ will only remain viable outside the body for a few hours,
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器官只会在体外保持有效几个小时,
02:20
so it needs to reach its recipient as fast as possible.
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所以它需要尽可能快的 到达它的接收者。
02:24
Once the heart arrives, the recipient is put under general anesthesia.
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一旦心脏到达, 接受者会被全身麻醉。
02:29
The surgeon makes an incision down the length of the chest,
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外科医生会沿着胸部的 长度做一个切口,
02:33
cutting through the breastbone to separate the rib cage
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穿过胸骨来分离肋骨
02:36
and expose the heart.
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并暴露心脏。
02:37
To keep blood flowing while they remove the damaged organ,
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当他们移除受损器官时, 为了保持血液流动,
02:40
surgeons use a cardiopulmonary bypass machine.
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外科医生会 使用心肺旁路机。
02:44
This takes over the heart's job,
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这接管了心脏的工作,
02:46
generating enough force to push blood through the patient's circulatory system.
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产生足够的力量来推动血液 并把它泵入患者的循环系统。
02:52
After the old heart is removed,
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旧的心脏取出来后,
02:54
the surgeon begins sewing the donor heart into place.
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外科医生开始缝纫 捐赠的心脏到位。
02:58
This is an incredibly precise process, where each blood vessel and artery
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这是一个非常精确的过程, 每个血管和动脉
03:02
must be carefully attached to avoid leaks.
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都必须小心的连接 以避免泄漏。
03:07
The procedure can last several hours,
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这个过程可以持续几个小时,
03:09
potentially longer if there’s scar tissue from previous surgeries.
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如果有从之前的手术得到的 疤痕组织的话可能会更长。
03:13
Once it’s finished, the bypass machine is turned off
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一旦完成, 旁路机会被关上
03:16
and blood is allowed to flow into the aorta.
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和然后血液就可以 流入大动脉。
03:20
Doctors carefully monitor the new heart to ensure it’s beating on its own
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在缝合接受者之前,
03:24
before sewing the recipient back up.
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医生会仔细的监测新心脏 以确保它是自己在跳动。
03:27
Even after the procedure is complete, there's still work to be done.
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即使在手术完成后, 还有工作要做。
03:31
Surgeons are unable to directly connect the heart
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外科医生无法直接连接心脏
03:34
to the recipient’s nervous system,
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到接受者的神经系统,
03:36
and it can take years for the body to fully innervate the new organ.
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身体可能需要数年时间 来充分支配新器官。
03:42
During this period, the transplanted organ has a higher resting heart rate
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在此期间,移植的器官 会有一个较高的静息心率
03:47
and risk of stroke, making exercise difficult and dangerous.
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和中风的风险,让做运动 变得困难和危险。
03:51
And since it’s incredibly rare to find a perfect match
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而且因为能找到捐赠者
03:54
between donor and recipient,
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和接受者的 完美匹配非常罕见,
03:56
the immune system will also have some response to the new heart.
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免疫系统也会 对新心脏有一些反应。
04:00
Immunosuppressive drugs can help manage the risk of rejection,
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免疫抑制药物可以帮助 控制拒绝的风险,
04:04
but they also leave patients open to contracting dangerous infections.
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但他们也可以让病人 感染危险的病毒。
04:09
It requires constant monitoring and testing to balance these two concerns.
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需要持续的监督 和测试来平衡这两个问题。
04:14
Despite these challenges, about 70% of heart transplant recipients survive
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尽管存在这些挑战,约 70% 的心脏移植受者在手术后,
04:19
for at least five years after the operation,
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存活了至少五年,
04:22
and just over 20% live another 20 years.
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超过 20% 的人 还能再活 20 年。
04:26
So when this procedure is successful, it's truly lifesaving.
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所以当这个手术成功时, 它真的是可以救命的。
04:30
Unfortunately, people in developing countries are often unable
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不幸的是,在不发达的 国家的人们往往无法
04:33
to access this surgery,
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接触这个手术,
04:35
and many viable hearts can’t be donated due to legal and regulatory issues.
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由于法律和监管问题, 很多有可行的心脏无法被捐赠。
04:41
Thousands of people remain on waiting lists,
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仍有数千人 在等候名单上,
04:44
and many are never able to find a suitable donor.
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而许多人永远无法 寻找合适的捐赠者。
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