心臓移植実施施設としての使命―東京女子医科大学の在り方

Mission as a Heart Transplantation Institute in Japan：Role of Tokyo Women’s Medical University in Development of Advanced Heart Failure Therapy

東京女子医科大学は日本の心臓移植医療に黎明期から携わり，その苦悩と発展の歴史を共有してきた．2001年7月に当院初の心臓移植が行われて以降，心臓移植実施施設としての使命を果たすべく日々邁進している．補助人工心臓（VAD）治療の発展を経て，本邦の心臓移植が「標準治療」になりつつある今何をすべきか．われわれの施設における移植医療の現状を報告するとともに，今後に向けた本学の在り方を考える．

Tokyo Women’s Medical University has a long history with leading development in the field of cardiovascular surgery in Japan, including ventricular assist device （VAD） and heart transplantation （HT）. Our institute has performed implantable VAD implantation in 73 patients with refractory heart failure as a bridge to transplantation. The long-term survival rate of that showed 94％, 85％, and 61％ in 1, 3, and 5 years, respectively. In addition, orthotopic HT has been provided for 38 patients, with survival after both 10 and 20 years shown to be 85％.

In this era of destination therapy, it is considered that VAD and HT treatments will become standardized options for heart failure cases even in Japan. To achieve this target, we re-organized our heart team named “BIND” in 2018, providing a more seamless multidisciplinary approach. We believe that these actions can contribute to the development of HT in our country.