Heart and Combined Heart-Kidney Transplantation in Patients With Concomitant Renal Insufficiency and End-Stage Heart Failure
Heart and Combined Heart-Kidney Transplantation in Patients With Concomitant Renal Insufficiency and End-Stage Heart Failure
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DOI：
10.1111/ajt.12522
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发表时间：
2014-02-01
影响因子：
8.8
通讯作者：
Mallidi, H. R.
中科院分区：
文献类型：
--
作者：
Schaffer, J. M.;Chiu, P.;Mallidi, H. R.
对于适合进行离体心脏移植（HRT）的终末期心力衰竭（ESHF）患者，透析依赖（DD）被认为是心肾联合移植（HKT）的适应症。HKT在非透析依赖性肾功能不全（NDDRI）的ESHF移植候选者中仍存在争议。使用器官共享联合网络数据，我们检查了等待HKT或HRT的DD和NDDRI患者的移植累积发生率和死亡率。在所有组中，3个月等候名单死亡率均令人沮丧：HRT和HKT列出的DD患者分别为31%和21%，HRT和HKT列出的NDDRI患者分别为12%和7%。HKT组移植后5年生存率高于HRT组（73% vs. 51%，p
In patients with end-stage heart failure (ESHF) who are candidates for isolated heart transplant (HRT), dialysis dependence (DD) is considered an indication for combined heart-kidney transplantation (HKT). HKT remains controversial in ESHF transplant candidates with nondialysis-dependent renal insufficiency (NDDRI). Using United Network for Organ Sharing data, we examined the cumulative incidences of transplant and mortality in patients with DD and NDDRI waitlisted for HKT or HRT. In all groups, 3-month waitlist mortality was dismal: 31% and 21% for HRT- and HKT-listed patients with DD and 12% and 7% for HRT- and HKT-listed patients with NDDRI. Five-year posttransplant survival was improved in HKT recipients compared with HRT recipients for both patients with DD (73% vs. 51%, p