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肺移植和心脏移植后的肾脏并发症

Renal Complications Following Lung Transplantation and Heart Transplantation.

作者信息

Puttarajappa Chethan M, Bernardo Jose F, Kellum John A

机构信息

Renal-Electrolyte Division, University of Pittsburgh Medical Center, 3550 Terrace Street, Pittsburgh, PA 15261, USA.

Renal-Electrolyte Division, University of Pittsburgh Medical Center, 3550 Terrace Street, Pittsburgh, PA 15261, USA.

出版信息

Crit Care Clin. 2019 Jan;35(1):61-73. doi: 10.1016/j.ccc.2018.08.009. Epub 2018 Oct 25.

Abstract

Renal complications are common following heart and/or lung transplantation and lead to increased morbidity and mortality. Renal dysfunction is also associated with increased mortality for patients on the transplant wait list. Dialysis dependence is a relative contraindication for heart or lung transplantation at most centers, and such patients are often listed for a simultaneous kidney transplant. Several factors contribute to the impaired renal function in patients undergoing heart and/or lung transplantation, including the interplay between cardiopulmonary and renal hemodynamics, complex perioperative issues, and exposure to nephrotoxic medications, mainly calcineurin inhibitors.

摘要

心脏和/或肺移植后肾脏并发症很常见,会导致发病率和死亡率增加。肾功能不全也与移植等待名单上患者的死亡率增加有关。在大多数中心,依赖透析是心脏或肺移植的相对禁忌证,此类患者通常会被列入同时进行肾移植的名单。心脏和/或肺移植患者肾功能受损有多种因素,包括心肺和肾脏血流动力学之间的相互作用、复杂的围手术期问题以及接触肾毒性药物,主要是钙调神经磷酸酶抑制剂。

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