Seydoux C, Gillard Berguer D, Wauters J P, Mosimann F, Stumpe F, Hurni M, Ruchat P, Aubert V, Sadeghi H, Goy J J
Division de cardiologie, Centre Hospitalier Universitaire Vaudois, Lausanne.
Schweiz Med Wochenschr. 1996 Dec 14;126(50):2181-3.
Combined heart and renal transplantation from the same donor is an uncommon procedure. We describe the case of a patient with prior kidney transplantation whose renal graft had to be removed a few years later because of chronic rejection. The patient then developed severe hypertensive and ischemic left ventricular dysfunction. Combined heart and kidney transplantation was performed several years after the first renal transplantation. This observation is the first description of a combined heart and kidney transplantation after removal of a former renal graft whose failure was due to chronic rejection. Great care was taken to avoid identical MHC antigens (HLA-A; -B; -DR) between the two donors, to prevent recurrent rejection of the grafted organs. After 18 months, no rejection was detected in either organ. This case report confirms the feasibility of this complex procedure, provided care is taken to avoid identical HLA groups between the two donors so as to reduce immunological complications.
来自同一供体的心脏和肾脏联合移植是一种不常见的手术。我们描述了一例曾接受过肾脏移植的患者，其肾移植几年后因慢性排斥反应而不得不切除移植肾。该患者随后出现严重的高血压和缺血性左心室功能障碍。在首次肾移植几年后进行了心脏和肾脏联合移植。本观察是首次描述因慢性排斥反应导致先前移植肾失败后进行的心脏和肾脏联合移植。我们非常小心地避免两个供体之间存在相同的主要组织相容性复合体抗原（HLA - A、- B、- DR），以防止移植器官再次发生排斥反应。18个月后，两个器官均未检测到排斥反应。本病例报告证实了这一复杂手术的可行性，前提是注意避免两个供体之间存在相同的HLA组，以减少免疫并发症。
