Survival and Allograft Rejection Rates after Combined Heart and Kidney Transplantation in Comparison with Heart Transplantation Alone
Survival and Allograft Rejection Rates after Combined Heart and Kidney Transplantation in Comparison with Heart Transplantation Alone
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DOI：
10.1016/j.transproceed.2011.08.095
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发表时间：
2011-12-01
影响因子：
0.9
通讯作者：
Trento, A.
中科院分区：
文献类型：
--
作者：
Czer, L. S. C.;Ruzza, A.;Trento, A.
背景实体多器官移植的作用仍有待确定。我们比较了心肾联合移植（HKT）和单纯心脏移植（HT）的经验，并评估了这两组患者的存活率和无同种异体移植排斥反应的情况。我们回顾了1992年6月至2009年3月期间接受HKT（n = 30）或HT（n = 440）的患者的临床结局。对患者的基线特征、围手术期因素、排斥反应发生率和生存率进行了检查。两组患者的年龄、性别、心脏病病因、心功能分级、术前左心室射血分数、舒张末期内径、心输出量或移植等待名单状态无显著差异。HKT患者的血清肌酐水平较高（所有比较P 0.05）。HKT与HT单药治疗相比，具有极佳的生存率和相似的肾功能。终末期心脏和肾衰竭患者可考虑HKT。
Background. The role of solid multiorgan transplantation remains to be determined. We compared our experience with combined heart-kidney transplantation (HKT) and heart transplant alone (HT), and assessed patient survival rates and freedom from allograft rejection in these two patient groups.Methods. We reviewed the clinical outcomes of patients undergoing HKT (n = 30) or HT (n = 440) between June 1992 and March 2009. Baseline patient characteristics, perioperative factors, incidence of rejection, and survival were examined.Results. There were no significant differences between the two groups for age, gender, etiology of heart disease, functional class, preoperative left ventricular ejection fraction, end-diastolic diameter, cardiac output, or transplant waitlist status. Patients with HKT had a higher serum creatinine level (P .05 for all comparisons).Conclusions. HKT offers excellent survival and similar renal function when compared with HT alone. Patients with end-stage cardiac and renal failure can be considered for HKT.