本邦における補助人工心臓と心臓移植の現状とトピック

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  • 田ノ上 禎久
    九州大学大学院医学研究院重症心肺不全講座
  • 塩瀬 明
    九州大学大学院医学研究院臨床医学部門循環器外科

書誌事項

タイトル別名
  • The Present Situation and Clinical Topics of Ventricular Assist Device and Heart Transplantation in Japan
  • ホンポウ ニ オケル ホジョ ジンコウ シンゾウ ト シンゾウ イショク ノ ゲンジョウ ト トピック

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Surgical treatment for heart failure includes coronary artery bypass grafting to ischemic heart disease, valvular disease surgery such as mitral valvuloplasty, left ventricular restoration, ventricular assist device (VAD), and heart transplantation. In addition, HeartSheet which is regenerative medicine using autologous skeletal myoblast sheets has been started from the spring of 2016. Formal insurance reimbursement of implantable LVAD was obtained in April 2011, and the life prognosis of patients with severe heart failure improved markedly. However, the indication for implantable LVAD is limited to bridge use for heart transplantation. Implantable LVAD cannot be implanted in patients over 65 years old under health insurance because the adaptive age of heart transplantation in Japan is under 65 years old. It is a problem that the indication of implantable LVAD is identical to that of heart transplantation. Clinical trial of destination therapy is in progress for the purpose of optimizing the implantable LVAD indication. I strongly pray that VAD treatment including destination therapy (DT) and transplant medical treatment based on good intentions will be accepted socially as general treatment.

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