Kebschull L, Schleicher C, Palmes D, Sindermann J, Suwelack B, Senninger N, Wolters H
Department of General and Visceral Surgery, University of Muenster, Muenster, Germany.
Thorac Cardiovasc Surg. 2012 Feb;60(1):57-63. doi: 10.1055/s-0031-1299574. Epub 2012 Jan 10.
Renal allograft outcome in heart-kidney transplantation (HKTx) might be affected by hemodynamic instability and high levels of calcineurin inhibitor-dependent immunosuppression.
From November 1999 to March 2008, 13 patients who received HKTx were compared with a matched control group of 13 kidney transplantation (KTx) recipients with similar cardiovascular risk factors. Graft function, rejection periods, and patient survival were analyzed.
Renal allograft rejection was noted in three patients (23%) after HKTx and in four patients (31%) after KTx. Serum creatinine levels were comparable at 1 week, 1 month, 1, 2, and 3 years after transplantation. Patient survival rates at 1, 2, and 3 years were 100% for HKTx recipients and 100, 92, and 92% for isolated KTx patients. Graft survival was 92% at 1, 2, and 3 years after HKTx and 100% at 1 year and 92% at 2 and 3 years after isolated KTx.
Our results with excellent long-term graft function and survival after combined HKTx indicate that this procedure is a valuable option for a growing number of patients suffering from coexistent cardiac and renal failure.
心脏-肾脏联合移植（HKTx）中肾移植的结局可能受血流动力学不稳定以及高水平的钙调神经磷酸酶抑制剂依赖性免疫抑制的影响。
1999年11月至2008年3月，将13例接受HKTx的患者与13例具有相似心血管危险因素的肾移植（KTx）受者匹配对照组进行比较。分析移植肾功能、排斥反应期和患者生存率。
HKTx后3例患者（23%）出现肾移植排斥反应，KTx后4例患者（31%）出现。移植后1周、1个月、1年、2年和3年时血清肌酐水平相当。HKTx受者1年、2年和3年的患者生存率为100%，单纯KTx患者分别为100%、92%和92%。HKTx后1年、2年和3年的移植肾生存率为92%，单纯KTx后1年为100%，2年和3年为92%。
我们联合HKTx后长期移植肾功能和生存率良好的结果表明，对于越来越多同时患有心脏和肾衰竭的患者而言，该手术是一个有价值的选择。
