Seeing that Xie didn't want to say anything, the gentle Pan took the initiative to explore the way ahead: "I think the most important thing is suitability."
If Cao Yong nodded to his junior fellow apprentice's answer, it seemed that many of his junior fellow apprentices were also talented.
To put it simply, Mr. Pan’s words refer to the inappropriate parts of the organ transplant process, which doctors may be able to make suitable through clever methods.
"Yingying, what do you think?" Pan Shihua asked Xie for his insightful opinion.
Senior Brother Cao and Student Wei looked over as if they wanted to hear what she had to say. Xie Wanying said, "Where the limit of suitable technology is, where the upper limit of organ transplant surgery may be."
This is a further academic interpretation of Pan’s words.
Wei and Pan's eyes seemed to be lit up with little stars. Cao Yong couldn't close his smile.
How do you understand what Xie said?
Let me first talk about a liver transplant surgery I have seen before. At that time, Xie participated in the operation and offered suggestions. The doctors attributed the difficulties in the operation to the fact that the donor liver was too large and not suitable, and it had to be cut smaller, which was a problem of suitability.
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The donor-recipient ratio has always been a basic threshold in all organ transplant operations.
Liver transplant surgery has such technical difficulties, and the same applies to heart transplant surgery.
Can we do the same as liver transplantation, where a large heart can be cut into a smaller size to suit a patient? Xie told reporter Li that, for example, a pediatric donor heart can be 2.5 times larger than the recipient's original heart.
As for this crux, anyone with a little anatomical knowledge knows that the heart cannot be like the liver. The liver and the heart are two organs that are completely different in terms of morphology, function, and structure.
The overall structure of the heart is closely related to its function. The liver is not like that. The function of the liver mainly depends on the liver tissue. This means that one donor liver can be cut into two to be used by two recipients. How can this be possible with the heart? The donor-recipient ratio for the heart is really stricter than that for liver transplantation. Here is another little-known point. For liver transplantation, there is no need to worry about the donor being too small. On the contrary, as Mr. Xie said, the ratio of the pediatric donor heart should not be less than 0.9 of the original heart of the recipient. This shows that the acceptance of small donor ratios is much lower in heart transplantation than in liver transplantation.
Why is this?
The main function of the heart is to output and recycle blood throughout the body. It is not a big problem if the donor is a little bigger, because many patients who need heart transplants have heart disease, which causes the myocardium to expand and the heart volume to increase. The volume of the space that accommodates the heart also increases, so it can accept a larger heart. Of course, it cannot be too big, which will also cause secondary hypertension and other problems after surgery.
In contrast, the problem caused by too small a donor is more difficult to solve: low cardiac output. Many heart disease patients in the terminal stage die from this problem. If the transplanted heart fails to solve this important problem, the result is likely to be a waste of the transplant.
In clinical practice, it becomes: young children should try to choose older donor hearts. Female patients should choose male patients' hearts. Male patients should be very cautious when accepting hearts from patients who are much smaller than their own weight.
These are exactly what Xie pointed out. The "suitability" technical limits determine the technical limits of organ transplantation, and they are all difficulties that need to be solved during the operation.
Just based on the ratio, the threshold for heart transplantation is higher than that for liver transplantation. Heart transplantation is definitely more difficult than liver transplantation, otherwise it would be unworthy of the title of the two major surgical specialties.
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