Mimura Imari, Kawarazaki Hiroo, Momose Toshimitsu, Shibagaki Yugo, Fujita Toshiro
Department of Nephrology and Endocrinology.
Department of Radiology , University of Tokyo School of Medicine , Tokyo.
NDT Plus. 2009 Dec;2(6):479-81. doi: 10.1093/ndtplus/sfp110. Epub 2009 Aug 23.
Patients with long dialysis vintage have low cardiac output for various reasons. Although kidney transplantation is known to improve cardiac mortality, patients are sometimes evaluated as contraindicated for transplantation because of cardiac risk. We successfully performed kidney transplantation for a patient with a long dialysis vintage and dilated cardiomyopathy. Sequential (123)I-metaiodobenzylguanidine ((123)I-MIBG) scintigraphy suggested that amelioration of uraemia improved cardiac function. Kidney transplantation for patients with severely impaired cardiac function is safe and effective under careful perioperative monitoring irrespective of dialysis vintage. Sequential (123)I-MIBG scintigraphy can be used as an evaluation tool for the improvement in cardiac function.
透析龄长的患者由于各种原因心输出量较低。尽管已知肾移植可改善心脏死亡率，但有时患者因心脏风险而被评估为移植禁忌。我们成功地为一名透析龄长且患有扩张型心肌病的患者进行了肾移植。序贯（123）I-间碘苄胍（（123）I-MIBG）闪烁扫描显示尿毒症的改善改善了心脏功能。对于心功能严重受损的患者，无论透析龄如何，在仔细的围手术期监测下进行肾移植是安全有效的。序贯（123）I-MIBG闪烁扫描可用作心脏功能改善的评估工具。
