Hanna Ramy M, Cruz Daniel, Selamet Umut, Hasnain Huma, Kwon Murray, Baas Arnold, Wilson James
David Geffen-UCLA School of Medicine, Los Angeles, California, USA.
Department of Medicine, Division of Nephrology, Ronald Reagan Medical Center, Los Angeles, California, USA.
Hemodial Int. 2018 Jul;22(3):E36-E38. doi: 10.1111/hdi.12631. Epub 2018 Jan 23.
Severe heart failure is increasingly being managed by cardiac transplantation, and in some cases mechanical support devices serve as destination therapies. Left ventricular assist devices (LVADs) were approved for destination therapy for end stage heart failure patients before the more advanced total artificial heart modality became available. One common complication of mechanical assist device placement is acute kidney injury. Historically, patients with mechanical support devices have had to have inpatient hemodialysis until combined heart kidney transplant. Though, some units have started accepting LVAD patients in outpatient dialysis clinics. The cost of in center hemodialysis remains high and home dialysis modalities are becoming increasingly popular. We report the first patient with an LVAD to undergo training and successful home hemodialysis while awaiting combined heart kidney transplantation.
严重心力衰竭越来越多地通过心脏移植来治疗，在某些情况下，机械支持装置可作为终末期治疗手段。在更先进的全人工心脏出现之前，左心室辅助装置（LVAD）已被批准用于终末期心力衰竭患者的终末期治疗。机械辅助装置植入的一个常见并发症是急性肾损伤。从历史上看，使用机械支持装置的患者在接受心脏肾脏联合移植之前必须进行住院血液透析。不过，一些科室已开始在门诊透析诊所接收LVAD患者。中心血液透析的成本仍然很高，家庭透析方式越来越受欢迎。我们报告了首例植入LVAD的患者在等待心脏肾脏联合移植期间接受培训并成功进行家庭血液透析的病例。
