QA：可以使用的人造器官有哪些？网友回答“举个例子，拯救心脏病患者的人工心脏 - 左心室辅助装置”
What are some artificial versions of human organs that can be used?
译文简介
它是一个连续流动的心脏，这意味着，尽管你是直立的、清醒的、说话的、生活的——你将没有脉搏。
正文翻译
Dr. Frazier stood holding the still-living man’s heart in his hands.
弗雷泽医生站在那里，手里捧着那个仍然活着的人的心脏。
弗雷泽医生站在那里，手里捧着那个仍然活着的人的心脏。
With his hands, he softly squeezed the heart over and over again, pumping blood into the man’s body, as he maintained eye contact with the struggling 24-year-old patient.
他轻轻地用手挤压着心脏，一遍又一遍地将血液泵入患者的身体，同时与这位24岁的患者保持着目光交流。
他轻轻地用手挤压着心脏，一遍又一遍地将血液泵入患者的身体，同时与这位24岁的患者保持着目光交流。
Their other attempts had failed. There was nothing else the surgeons could do. He was now being kept alive because Dr. Frazier was manually pumping his heart with his hands.
其他的手段都已经失败了，外科医生们已经无能为力。他现在还活着，因为弗雷泽医生用手手动地为他的心脏泵血。
其他的手段都已经失败了，外科医生们已经无能为力。他现在还活着，因为弗雷泽医生用手手动地为他的心脏泵血。
Dr. Frazier, still a resident, was then told by his supervisor to stop, that nothing else could be done. And ultimately Frazier did, and had to watch as the man’s life left his eyes.
弗雷泽医生，当时还只是个住院医生，随后被他的主管告知停止操作，因为已经无药可救了。最终，弗雷泽不得不看着这个人的生命从他的眼中消逝。
原创翻译：龙腾网 http://www.ltaaa.cn 转载请注明出处
弗雷泽医生，当时还只是个住院医生，随后被他的主管告知停止操作，因为已经无药可救了。最终，弗雷泽不得不看着这个人的生命从他的眼中消逝。
原创翻译：龙腾网 http://www.ltaaa.cn 转载请注明出处
This was the beginning of his journey to an unprecedented invention. Frazier wondered if he could manually pump a man’s heart with his hand, why couldn’t he create a replacement that does the same thing?
这是他迈向一项前所未有的发明之旅的开始。弗雷泽想知道，如果他能用手手动泵送（泵送血液）一个人的心脏，为什么他不能创造一个能做同样事情的替代品？
这是他迈向一项前所未有的发明之旅的开始。弗雷泽想知道，如果他能用手手动泵送（泵送血液）一个人的心脏，为什么他不能创造一个能做同样事情的替代品？
In the U.S. alone, 5 million people suffer from heart failure. Meanwhile, only 2,000 hearts become available for a heart transplant on a yearly basis.
仅在美国，就有500万人患有心力衰竭。与此同时，每年只有2000颗心脏可用于心脏移植。
仅在美国，就有500万人患有心力衰竭。与此同时，每年只有2000颗心脏可用于心脏移植。
Great demand lies in the chasm of this scarcity. That demand is marked by desperation.
巨大的需求隐藏在这个短缺鸿沟中。这种需求充满了绝望。
巨大的需求隐藏在这个短缺鸿沟中。这种需求充满了绝望。
Frazier’s first invention was a support to the left valve of the heart, which replaced a failing left valve of the heart, giving strength to a weakened heart.
弗雷泽的第一个发明是心脏左瓣膜的支架，它取代了心脏衰竭的左瓣膜，为虚弱的心脏提供了力量。
弗雷泽的第一个发明是心脏左瓣膜的支架，它取代了心脏衰竭的左瓣膜，为虚弱的心脏提供了力量。
But his next work, alongside very accomplished and bright people, was the creation of a left ventricular assist device (LVAD) heart. An LVAD heart is artificial:
但他的下一项工作，与非常有成就和聪明的人一起，是创造一个左心室辅助装置(LVAD)心脏。LVAD心脏是人造的:
但他的下一项工作，与非常有成就和聪明的人一起，是创造一个左心室辅助装置(LVAD)心脏。LVAD心脏是人造的:
It has been in the development pipeline for years. It has already been used on cows and has once been used to extend the life of an on-death’s-door patient for an additional five weeks.
多年来，它一直处于开发过程中。它已经被用于奶牛身上，并曾被用来将濒临死亡的患者的寿命再延长五周。
This heart could very well be the future of heart transplants, and it may extend your and my life by years when death comes knocking on our door.
这颗心脏很可能成为心脏移植的未来，当死亡来敲我们的门时，它可能会延长你我的寿命。
这颗心脏很可能成为心脏移植的未来，当死亡来敲我们的门时，它可能会延长你我的寿命。
But this heart comes with one spooky twist:
但这颗心有一个令人毛骨悚然的转折:
但这颗心有一个令人毛骨悚然的转折:
It is a continuous-flow heart, which means, despite you being upright, awake, talking, living— you will have no pulse.
它是一个连续流动的心脏，这意味着，尽管你是直立的、清醒的、说话的、生活的——你将没有脉搏。
它是一个连续流动的心脏，这意味着，尽管你是直立的、清醒的、说话的、生活的——你将没有脉搏。
评论翻译
很赞 ( 1 )
收藏
From my experience at a Cardiac surgery program that put in LVADs, most patients do actually have pulse. It’s just that the pulse isn’t strong enough to keep the patient alive. Most have a blood pressure like 80/70, with the narrow pulse pressure difference being hard to palpate unless you check the femoral artery on a non-obese patient.
Because the heart is still beating you can also get arrhythmias. We used to have monitors go off all the time when the patient’s hearts went into ventricular tachycardia for a minute or two overnight.
从我在心脏手术项目中植入左心室辅助装置的经验来看，大多数病人确实有脉搏。只是脉搏不够强，不足以维持病人的生命。大多数患者的血压都在80/70左右，除非检查非肥胖患者的股动脉，否则很难感觉到脉搏压差很窄。
因为心脏还在跳动，你也可能会有心律失常。我们过去常常关闭监测器，当病人的心脏在夜间出现室性心动过速一两分钟的时候。
If it is a “continuous flow” heart as mentioned in the answer, would there actually be beats that produce pulses?
如果它是上面提到的“连续流动”的心脏，那么真的会有产生脉搏的心跳吗？
It’s attached to the existing heart, which still beats in a weak and often irregular fashion. These beats are often strong enough to be detected, just not strong enough to move the blood around on their own.
This makes sense, as most patients who receive LVADs did not require artificial life support (ECMO, Balloon pump, Impella) in the weeks leading up to their scheduled operations and were being kept alive by their own hearts. This heart activity doesn’t just vanish the moment the LVAD is placed.
它连接在原有的心脏上，原有的心脏仍然会以微弱和经常不规则的方式跳动。这些跳动通常足够强大以被检测到，但不足以单独推动血液流动。这是有道理的，因为接受左心室辅助装置植入的大多数患者在手术前的几周内并不需要人工生命支持（ECMO、气球泵、Impella），他们是靠自己的心脏维持生命。这种心脏活动不会在植入左心室辅助装置的那一刻就消失。
How can they created enough place to add that artificial heart next to your heart?
他们是如何创造出足够的空间在你的心脏旁边添加人工心脏的?
This was a concern for earlier generation LVADs and both the Heartmate 1 and 2 were actually implanted in the abdomen. As the devices got smaller and switched from inline flow (Heartmate 2) to the more compact centrifugal system used by the Heartmate 3 they were able to fit the system in the thorax without displacing too much lung tissue. A failing heart gets huge as it stretches and fills with fluid, improving flow can create enough space to fit the small teacup sized Heartmate 3.
这是早期左心室辅助装置的一个问题，Heartmate 1（左心室辅助装置）和Heartmate 2实际上都是植入腹部的。随着设备变得越来越小，并从内联流(Heartmate 2)切换到Heartmate 3使用的更紧凑的离心系统，他们能够将系统安装在胸腔中，而不会移位太多的肺组织。衰竭的心脏会随着拉伸和充满液体而变得巨大，改善血流可以为小茶杯大小的Heartmate 3创造足够的空间。
Heartmate 1
Heartmate 2
Heartmate 3
Carl Jacobson
Actually the main problem with these artificial hearts is that they create a massive autoimmune response in the body and are eventually rejected. Even artificial joints have to be redone every 5 years or so, to clean out the decomposed tissue around the artificial joint. The real ‘Big Development’ is stem cell and cloned replacement organs and joints, that the body won’t detect as being a foreign body.
实际上，这些人工心脏的主要问题是它们在体内引起了大规模的自身免疫反应，最终被排斥。即使是人工关节每5年左右也必须重新做一次手术，清除人工关节周围腐烂的组织。真正的“大进展”是干细胞和克隆替代器官和关节，身体不会检测到它们是异物。
I think your assertion that artificial joints have to be redone every 5 years is not true, at least not universally. My father has two artificial hips, one of which is probably about 10 years old already, and his doctors seem to think they should last another 10+ years with no issues. I'm sure autoimmune response is a real problem, and a heart is very different from a hip, but your comment seems to be a bit of an exaggeration.
我认为你所说的人工关节每5年就必须重新做手术的说法并不正确，至少不是普遍情况。我的父亲有两个人工髋关节，其中一个可能已经有大约10年了，他的医生似乎认为他们再坚持10年以上也没有问题。我相信自身免疫反应是一个真正的问题，而且心脏与髋关节非常不同，但是你的评论似乎有点夸张。
You’re correct - 5 years is probably an exaggeration and newer artificial hips may last longer without needing to be cleaned up and replaced.
BUT the fact is that any artificial implant into the human body will cause an auto-immune reaction and gradually kill the tissue around it.
Shoot, I had a root canal fall out several months ago - it was almost 20 years old, but after it fell out I cleaned out the hole with a water pik and it stunk like rotting blood and tissue.
你是对的——5 年可能有点夸张，较新款的人造髋关节可能会持续更长时间而无需清理和更换。
但事实是，任何人工植入物进入人体都会引起自身免疫反应，并逐渐杀死周围的组织。
哎呀，几个月前我有一个根管脱落——它已经快 20 年了，但在它脱落后我用水枪清理了洞并且它像腐烂的血液和组织那样发臭。
原创翻译：龙腾网 http://www.ltaaa.cn 转载请注明出处
"BUT the fact is that any artificial implant into the human body will cause an auto-immune reaction and gradually kill the tissue around it"
Fortunately, that is not the case. Foreign bodies do not cause an auto-immune reaction. Immune (not auto-immune) reactions to stainless steel, titanium, high density polythylene or polymethylmethacrylate are not really an issue. Infection is uncommon but potentially disastrous; mechanical wear and tear as people have joint replacements at a younger age and tend to live longer.
“但事实是，任何人工植入物进入人体都会引起自身免疫反应，并逐渐杀死周围的组织”
幸运的是，情况并非如此。异物不会引起自身免疫反应。对不锈钢、钛、高密度聚乙烯或聚甲基丙烯酸甲酯的免疫(非自身免疫)反应并不是真正的问题。感染并不常见，但可能是灾难性的；机械磨损和劣化问题是因为人们在更年轻的时候进行关节置换，而且活得更久。
Imagine being the physician for someone with an LVAD heart.
“alright Mr. Smith, time for your annual checkup.”
the doctor checks the patient’s pulse, and is startled to find that there is none.
“That’s odd. You don’t have a pulse… how are you alive again?”
“Oh, that? That’s just the LVAD doing its thing, doc.”
pretty sure the doctor would have a mini heart attack upon finding no pulse!
想象一下，作为带有左心室辅助装置的患者的医生是什么感觉。
“好的，史密斯先生，你的年度检查时间到了。”
医生检查患者的脉搏，惊讶地发现没有脉搏。
“这很奇怪，你没有脉搏……你怎么还活着？”
“哦，那个？那只是左心室辅助装置在发挥作用，医生。”
医生肯定会因为找不到脉搏而轻微心脏病发作！
Usually, they know about the heart, and what to expect, as they like to monitor these closely, but there is a story about this from Popular Science circa 2012:
"And here's where the story gets spooky. In November 2003, Frazier installed the newly approved HeartMate II to assist the failing heart of a young man from Central America who barely spoke English. His family members spoke none. So none of them fully understood Frazier's instructions to return to the hospital frequently for follow-up. The young man walked out of the hospital and disappeared.
When he finally showed up eight months later, Frazier held a stethoscope to his chest and was stunned to hear no heartbeat at all. None. Even more-sensitive instruments would have found nothing resembling a pulse. The young man's heart continued to flutter weakly, but it had effectively shut down. Although the HeartMate II had been designed to assist the heart, not replace it, in this case it seemed to be doing all the work: not just helping the left ventricle push oxygenated blood to the body, but pushing the blood hard enough to flow through the body, then back through the useless heart to the lungs, through the useless heart again, and into the pump to complete the loop and begin the process all over again. The reason the young man had never come back for follow-up, he told Frazier, was that he'd felt perfectly fine."
So, there is at least one accidental case!
通常情况下，他们了解LVAD的情况和预期，因为他们喜欢密切监视，但Popular Science在2012年有一篇关于这个的报道：
“在这里，故事变得毛骨悚然。2003年11月，弗雷泽为一位来自中美洲、英语几乎不会说的年轻人安装了新获批准的HeartMate 2来帮助衰竭的心脏。他的家人不会说英语。所以他们都没有完全理解弗雷泽的指示，要经常返回医院进行跟进。这位年轻人走出了医院，消失了。
八个月后，当他终于出现时，弗雷泽将听诊器放在他的胸前，惊讶地发现没有心跳。没有任何脉搏。即使是更敏感的仪器也无法找到任何类似脉搏的东西。这位年轻人的心脏继续微弱地颤动着，但实际上已经停止了。虽然HeartMate 2的设计是为了帮助心脏而不是替代心脏，但在这种情况下，它似乎正在做所有的工作：不仅帮助左心室将含氧血液推向身体，而且还将血液推得足够强劲，以便经过无用的心脏再次流向肺部，然后再次通过无用的心脏流回泵中完成循环，并重新开始整个过程。这位年轻人告诉弗雷泽，他没有回来进行跟进的原因是他感觉很好。”
因此，至少有一个意外的案例！
Er.. vampire?
呃..吸血鬼？
More of a zombie
更像活死人
that’s what i was going t say
这就是我要说的
I was about to suggest that the full-replacement heart have Bluetooth connectivity to let the owner know how well blood was flowing, but then I realized just how bad of an idea that would be in reality.
我本来想建议全面替换的心脏具备蓝牙连接，以便让所有者知道血液流动情况，但后来意识到这在现实中是一个多么糟糕的主意。
原创翻译：龙腾网 http://www.ltaaa.cn 转载请注明出处
So I'll be a living dead. Even though it is a marvelous achievement, but it's spooky as well.
所以我会成为一个活死人。 尽管这是一项了不起的成就，但也令人毛骨悚然。
That would be kinda cool Haha. No pulse. Wonder if it has activity sensors for increasing blood flow during exercise just like a regular heart would beat faster
那会有点酷哈哈。 没有脉搏。 想知道它是否有活动传感器来增加运动期间的血流量，就像普通心脏跳动更快一样
原创翻译：龙腾网 http://www.ltaaa.cn 转载请注明出处
“despite being upright, awake, talking, living— you will have no pulse.”
i can live with that …
“尽管你是直立的、清醒的、说话的、活着的——你还是没有脉搏。”
我可以忍受这一点 …