心脏和肾脏联合移植：初步临床经验。
Combined Heart and Kidney Transplantation: Initial Clinical Experience.
机构信息
Department of Cardiovascular Surgery, Instituto de Cardiologia do Distrito Federal, Brasília, Federal District, Brazil.
Transplant Unit, Instituto de Cardiologia do Distrito Federal, Brasília, Federal District, Brazil.
出版信息
Braz J Cardiovasc Surg. 2022 May 2;37(2):263-267. doi: 10.21470/1678-9741-2020-0720.
INTRODUCTION
Combined solid organ transplantation is infrequently performed in Brazil. The objective of this article is to present our initial experience with combined heart and kidney transplantation.
METHODS
From January 2007 to December 2019, four patients were submitted to combined heart and kidney transplantation. Their mean age was 55.7±4.4 years, and three (75%) patients were males. All patients had Chagas cardiomyopathy, two were hospitalized and inotrope dependent, and all patients were on preoperative dialysis (median of 12 months prior to transplant).
RESULTS
All patients survived and were in New York Heart Association functional class I at the latest follow-up (mean 34.7±17.5 months). Mean retarded kidney graft function was 22.9±9.7 days. One patient lost the kidney graft two years after the transplant due to Polyomavirus infection.
CONCLUSION
Our initial experience of combined heart and kidney transplantation was favorable in selected patients with advanced heart failure and end-stage kidney disease. It requires involvement of a dedicated multispecialty team throughout all the diagnostics and treatment steps.
简介
在巴西，联合实体器官移植的实施较为少见。本文旨在介绍我们在联合心脏和肾脏移植方面的初步经验。
方法
自 2007 年 1 月至 2019 年 12 月，共有 4 名患者接受了联合心脏和肾脏移植。他们的平均年龄为 55.7±4.4 岁，其中 3 名（75%）为男性。所有患者均患有恰加斯心肌病，2 名患者住院并依赖正性肌力药物，所有患者均在术前接受透析（移植前中位数为 12 个月）。
结果
所有患者均存活，且在最近的随访中（平均 34.7±17.5 个月）处于纽约心脏协会心功能分级 I 级。延迟的肾脏移植物功能恢复平均为 22.9±9.7 天。1 名患者在移植后 2 年因多瘤病毒感染而失去肾脏移植物。
结论
在患有晚期心力衰竭和终末期肾病的选定患者中，我们联合心脏和肾脏移植的初步经验是有利的。这需要一个专门的多学科团队参与所有诊断和治疗步骤。
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