背景：心脏同种异体带瓣管道（同种瓣）在心脏瓣膜置换中具有显著优势，但其来源受限于尸体或脑死亡供体，供体短缺成为临床应用的一大挑战。本研究探讨了利用心脏移植供体获取和保存同种瓣的方法，以缓解供体短缺并优化移植流程。方法：我们回顾性分析了2007年10月至2022年10月在本中心接受肺动脉瓣置换（PVR）且使用心脏移植供体同种瓣的患者情况。获取的同种瓣经过质量控制后进行冷冻保存，并在植入前解冻。共有60例接受或曾接受过法洛四联症（TOF）根治术的患者接受了同种瓣PVR。结果：供体年龄中位数为39.0岁，受体年龄中位数为5.1岁（四分位数间距：1.5~12.1岁）。随访中位时间为2.6年（四分位数间距：1.0~6.9年），5年、10年和15年总体生存率分别为94.0%、89.5%和89.5%。24例患者（40.0%）出现不良临床结局，其5年、10年和15年的无不良事件生存率分别为64.9%、53.4%和31.7%。回归分析显示，同种瓣的二叶化（OR=75.085，95% CI: 10.100~558.202，P＜0.001）以及术后早期瓣膜反流（OR=9.946，95% CI: 1.034~95.706，P=0.047）是影响临床预后的独立危险因素。结论：本研究表明，利用心脏移植供体获取的同种瓣在法洛四联症根治术中或术后PVR中可获得较好的短中期疗效。建议加强术后早期瓣膜反流的监测，以评估预后风险，并避免使用二叶化的同种瓣。

Background: Allograft valves offer significant advantages in valve replacement; however, their limited availability from cadaveric or brain-dead donors presents a considerable challenge. This study aims to share our experience in harvesting and preserving allograft valves from heart transplant recipients, addressing this shortage and streamlining the process. Method: We retrospectively analyzed patients who underwent pulmonary valve replacement (PVR) with or after the repaired Tetralogy of Fallot (rTOF) with allograft valves harvested from heart transplant recipients at our center between October 2007 and October 2022. The harvested valves were cryopreserved and thawed before implantation. Result: A total of 60 patients with or after repaired Tetralogy of Fallot (TOF) underwent PVR using these allografts. The median donor age was 39.0 years,while the median recipient age was 5.1 years (interquartile range:1.5~12.1 years). With a median follow-up of 2.6 years (interquartile range:1.0~6.9 years),the freedom from all-cause mortality at 5, 10, and 15 years was 94.0%, 89.5%, and 89.5%, respectively. Adverse clinical outcomes occurred in 24 patients (40.0%),with freedom from adverse events at 5, 10, and 15 years being 64.9%, 53.4%, and 31.7%, respectively. Bicuspidization of the allograft valve (odds ratio: 75.085; 95% confidence interval: 10.100~558.202, P＜0.001) and early postoperative regurgitation (odds ratio: 9.946; 95% confidence interval: 1.034~95.706, P=0.047) were identified as independent risk factors for adverse outcomes. Conclusion: Our findings suggest that allograft valves from heart transplant recipients can achieve favorable short- to mid-term outcomes for PVR in patients with repaired TOF. We recommend vigilant monitoring of early postoperative regurgitation as a potential indicator of poor prognosis and strongly advise against bicuspidization of implanted allograft valves.