Your heart beats more than 100,000 times a day.?In just a minute, it pumps over five liters of blood throughout your body.?But unlike skin and bones, the heart has a limited ability to repair itself.?So if this organ is severely damaged,?there’s often only one medical solution: replacing it.?Today, nearly 3,500 heart transplants are performed each year?in a complex and intricate procedure with no room for error.

你的心臟每天跳動(dòng) 超過(guò) 100,000 次。?在短短一分鐘內(nèi)，它就促使五升以上 的血液泵入你的全身。但與皮膚和骨骼不同的是，心臟 的自我修復(fù)能力有限。?所以如果這個(gè)器官嚴(yán)重受損，?它通常只有一種醫(yī)療解決方案： 更換它。如今，每年執(zhí)行 近 3,500 例心臟移植,?在錯(cuò)綜復(fù)雜的過(guò)程中, 沒(méi)有犯錯(cuò)的余地。

The process begins by testing potential recipients?to ensure they’re healthy enough for this demanding operation.?Doctors are especially concerned with identifying immunocompromising illnesses?or any other conditions that could compromise a patient's chance of survival.

首先要測(cè)試潛在的接受者?以確保他們足夠健康來(lái)接受這種艱難的手術(shù)。?醫(yī)生特別關(guān)心 識(shí)別免疫功能低下的疾病或任何其他可能 危及患者的生存機(jī)會(huì)的狀況。

The next step is to match an eligible recipient with a heart donor.?Donors are often comatose patients with no chance of being resuscitated?or victims of a fatal event whose hearts are still healthy.?In both cases, these patients need to be registered as an organ donor?or have their families give consent.?And even when a heart is available,?surgeons can’t just pair any donor with any recipient.?The recipient’s immune system will view a transplanted heart?as a foreign organism that must be attacked.?So doctors need to match recipients with donors that share their blood type?and have similar antigens.

下一步是匹配符合條件的心臟捐贈(zèng)者的接受者。?捐贈(zèng)者通常是沒(méi)有 復(fù)活的機(jī)會(huì)的昏迷患者?或心臟仍然健康的 致命事件受害者。?在這兩種情況下，這些患者都需要 登記為器官捐獻(xiàn)者，?或讓他們的家人同意。?即使有一顆心臟，?外科醫(yī)生不能直接配對(duì) 任何捐贈(zèng)者和任何接受者。?接受者的免疫系統(tǒng)將會(huì)把 移植的心臟看作為?必須受到攻擊的外來(lái)生物。?所以醫(yī)生需要匹配接受者 給跟他們有一樣血型?并具有相似抗原的捐贈(zèng)者。

If a match can be made, the surgery can begin.?Once the donor's heart is confirmed to be healthy,?the organ is immersed in an ice slush?and injected with a solution to induce cardiac arrest.?These treatments stop the heart from pumping?to ensure it can be removed cleanly.?Surgeons then place the organ in a mix of cold saline?and preservation solution.

如果可以匹配， 手術(shù)就可以開(kāi)始。?一旦捐贈(zèng)者的心臟 被確認(rèn)是健康的，?該器官會(huì)被浸入冰泥中?并被注入可以促使 心臟驟停的溶液。?這些治療使心臟停止跳動(dòng)?以確保它可以被 干凈利落地移除。?然后外科醫(yī)生將放置器官?在冷鹽水和保存 溶液的混合物中。

This is when the clock starts.?Disconnected from its blood supply,?the heart’s cells start taking on damage from lack of oxygen.?The organ will only remain viable outside the body for a few hours,?so it needs to reach its recipient as fast as possible.

這是時(shí)間開(kāi)始的時(shí)候。?與它的血液供應(yīng)斷開(kāi)，?心臟細(xì)胞開(kāi)始由于缺氧，受到損傷。?器官只會(huì)在體外保持有效幾個(gè)小時(shí)，?所以它需要盡可能快的 到達(dá)它的接收者。

Once the heart arrives, the recipient is put under general anesthesia.?The surgeon makes an incision down the length of the chest,?cutting through the breastbone to separate the rib cage?and expose the heart.?To keep blood flowing while they remove the damaged organ,?surgeons use a cardiopulmonary bypass machine.?This takes over the heart's job,?generating enough force to push blood through the patient's circulatory system.

一旦心臟到達(dá)， 接受者會(huì)被全身麻醉。?外科醫(yī)生會(huì)沿著胸部的 長(zhǎng)度做一個(gè)切口，?穿過(guò)胸骨來(lái)分離肋骨?并暴露心臟。?當(dāng)他們移除受損器官時(shí)， 為了保持血液流動(dòng)，?外科醫(yī)生會(huì) 使用心肺旁路機(jī)。?這接管了心臟的工作，?產(chǎn)生足夠的力量來(lái)推動(dòng)血液 并把它泵入患者的循環(huán)系統(tǒng)。

After the old heart is removed,?the surgeon begins sewing the donor heart into place.?This is an incredibly precise process, where each blood vessel and artery?must be carefully attached to avoid leaks.?The procedure can last several hours,?potentially longer if there’s scar tissue from previous surgeries.?Once it’s finished, the bypass machine is turned off?and blood is allowed to flow into the aorta.?Doctors carefully monitor the new heart to ensure it’s beating on its own?before sewing the recipient back up.

舊的心臟取出來(lái)后，?外科醫(yī)生開(kāi)始縫紉 捐贈(zèng)的心臟到位。?這是一個(gè)非常精確的過(guò)程， 每個(gè)血管和動(dòng)脈?都必須小心的連接 以避免泄漏。?這個(gè)過(guò)程可以持續(xù)幾個(gè)小時(shí)，?如果有從之前的手術(shù)得到的 疤痕組織的話可能會(huì)更長(zhǎng)。?一旦完成， 旁路機(jī)會(huì)被關(guān)上?和然后血液就可以 流入大動(dòng)脈。?在縫合接受者之前，?醫(yī)生會(huì)仔細(xì)的監(jiān)測(cè)新心臟 以確保它是自己在跳動(dòng)。

Even after the procedure is complete, there's still work to be done.?Surgeons are unable to directly connect the heart?to the recipient’s nervous system,?and it can take years for the body to fully innervate the new organ.?During this period, the transplanted organ has a higher resting heart rate?and risk of stroke, making exercise difficult and dangerous.?And since it’s incredibly rare to find a perfect match?between donor and recipient,?the immune system will also have some response to the new heart.?Immunosuppressive drugs can help manage the risk of rejection,?but they also leave patients open to contracting dangerous infections.?It requires constant monitoring and testing to balance these two concerns.

即使在手術(shù)完成后，還有工作要做。外科醫(yī)生無(wú)法直接連接心臟?到接受者的神經(jīng)系統(tǒng)，?身體可能需要數(shù)年時(shí)間來(lái)充分支配新器官。?在此期間，移植的器官會(huì)有一個(gè)較高的靜息心率?和中風(fēng)的風(fēng)險(xiǎn)，讓做運(yùn)動(dòng) 變得困難和危險(xiǎn)。?而且因?yàn)槟苷业骄栀?zèng)者?和接受者的 完美匹配非常罕見(jiàn)，免疫系統(tǒng)也會(huì) 對(duì)新心臟有一些反應(yīng)。?免疫抑制藥物可以幫助 控制拒絕的風(fēng)險(xiǎn)，?但他們也可以讓病人 感染危險(xiǎn)的病毒。需要持續(xù)的監(jiān)督和測(cè)試來(lái)平衡這兩個(gè)問(wèn)題。

Despite these challenges, about 70% of heart transplant recipients survive?for at least five years after the operation,?and just over 20% live another 20 years.?So when this procedure is successful, it's truly lifesaving.?Unfortunately, people in developing countries are often unable?to access this surgery,?and many viable hearts can’t be donated due to legal and regulatory issues.?Thousands of people remain on waiting lists,?and many are never able to find a suitable donor.

盡管存在這些挑戰(zhàn)，約 70%的心臟移植受者在手術(shù)后，?存活了至少五年，超過(guò) 20% 的人 還能再活 20 年。?所以當(dāng)這個(gè)手術(shù)成功時(shí)， 它真的是可以救命的。不幸的是，在不發(fā)達(dá)的 國(guó)家的人們往往無(wú)法?接觸這個(gè)手術(shù)，?由于法律和監(jiān)管問(wèn)題，很多有可行的心臟無(wú)法被捐贈(zèng)。?仍有數(shù)千人在等候名單上，而許多人永遠(yuǎn)無(wú)法 尋找合適的捐贈(zèng)者。