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肾移植受者心脏病的管理:一份基于全国德尔菲调查的SET/SEC/SEN共识文件。

Management of heart disease in renal transplant recipients: a national Delphi survey-based SET/SEC/SEN consensus document.

作者信息

García-Cosío María Dolores, Cruzado Josep María, Farrero Marta, Blasco Peiró María Teresa, Crespo Marta, Delgado Jiménez Juan Francisco, Díaz Molina Beatriz, Fernández Rivera Constantino, Garrido Bravo Iris Paula, López Jiménez Verónica, Melilli Edoardo, Mirabet Pérez Sonia, Pérez Tamajón María Lourdes, Rangel Sousa Diego, Rodrigo Calabia Emilio, Hernández Marrero Domingo

机构信息

Servicio de Cardiología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain.

Servicio de Nefrología, Hospital Universitario de Bellvitge, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Universidad de Barcelona, Barcelona, Spain.

出版信息

Rev Esp Cardiol (Engl Ed). 2025 Mar;78(3):252-262. doi: 10.1016/j.rec.2024.09.008. Epub 2024 Oct 21.

Abstract

Renal transplantation improves the survival and quality of life of patients with end-stage renal disease. Cardiovascular disease is the leading cause of morbidity and mortality in renal transplant recipients. The bidirectional relationship between renal and heart disease creates a unique clinical scenario that demands a comprehensive and personalized approach. This expert consensus, drafted by the Spanish Society of Transplantation, the Spanish Society of Cardiology, and the Spanish Society of Nephrology, aims to assess current practices and propose strategies for the management of heart disease in renal transplant recipients. A panel of Spanish nephrologists and cardiologists with expertise in renal and heart transplantation reviewed the scientific evidence concerning the current management of heart disease in renal transplant recipients. Subsequently, consensus statements were created through a 2-round Delphi methodology, resulting in 30 statements covering key topics such as the identification of renal transplant candidates, the management of heart disease in renal transplant recipients, and eligibility for combined heart-kidney transplantation in patients with both end-stage renal disease and cardiac disease. These consensus statements provide expert guidance for the management of heart disease in renal transplant recipients, an area where published clinical evidence remains limited.

摘要

肾移植可提高终末期肾病患者的生存率和生活质量。心血管疾病是肾移植受者发病和死亡的主要原因。肾脏疾病和心脏疾病之间的双向关系创造了一种独特的临床情况,需要采取全面且个性化的方法。本专家共识由西班牙移植学会、西班牙心脏病学会和西班牙肾脏病学会起草,旨在评估当前的实践情况,并提出肾移植受者心脏病管理策略。一个由在肾脏和心脏移植方面具有专业知识的西班牙肾脏病学家和心脏病学家组成的小组审查了有关肾移植受者心脏病当前管理的科学证据。随后,通过两轮德尔菲法制定了共识声明,产生了30条声明,涵盖了关键主题,如肾移植候选者的识别、肾移植受者心脏病的管理以及终末期肾病和心脏病患者联合心脏-肾脏移植的资格。这些共识声明为肾移植受者心脏病的管理提供了专家指导,而在这一领域,已发表的临床证据仍然有限。

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