心、肾联合移植术一例报告

Combined heart and kidney transplantation: Report of one case

目的 为了挽救 1例扩张型心肌病合并特发性肾小球硬化症肾功能不全的患者 ,进行同期心、肾联合移植。方法 在全麻体外循环支持下 ,进行一期心脏移植与肾脏移植。术后采用三联(环孢素A +霉酚酸酯 +类固醇激素 )免疫抑制疗法 ,并用赛尼哌诱导治疗。结果 受者至今存活 1年余 ,心肾功能良好 ,未发生明显急性排斥反应与严重感染 ,生活质量优良。结论 心、肾联合移植是治疗终末期心脏病合并严重肾脏器质性病变。

Objective To introduce a successful patient with end-stage dilated cardiomyopathy with concomitant idiopathic glomerulosclerosis undergoing combined heart and kidney transplantation (HKT).Methods Under general anaesthesia and CPB support, the patient with end-stage dilated cardiomyopathy with concomitant idiopathic glomerulosclerosis underwent HKT in a single operation in April 27, 2001. Immunosuppressive therapy following operation consisted of cyclosporine, steroids and mofetil-micofenolate, and induced with zenapax. Results At the time of writing this report, the patient had normal heart and kidney function and was in NYHA class I. There has not been any episode of acute rejection in both organs and severe infections. He was allowed to return to his previous job and was able to sustain full time after 2 months post-transplant.Conclusion HKT was an effective therapy for end-stage dilated cardiomyopathy with concomitant idiopathic glomerulosclerosis or renal failure.