心肾联合移植的应用与研究进展  

Application and research progress of combined heart and kidney transplantation

作　　者：杨艳蕾 阮永乐[1] YANG Yanlei;RUAN Yongle(Cardiovascular Surgery,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei,China)

机构地区：[1]武汉大学人民医院心血管外科,湖北武汉430060

出　　处：《武汉大学学报（医学版）》2024年第8期999-1003,共5页Medical Journal of Wuhan University

基　　金：国家自然科学基金青年项目(编号:81501376);中国博士后科学基金资助项目(编号:2017M620339)。

摘　　要：心肾联合移植近年来已成为患有终末期心脏疾病合并肾功能衰竭的患者的重要治疗方法,但目前临床上仍缺乏心肾联合移植实施的完善的标准规范。本文通过综述国内外心肾联合移植最新的临床及基础的研究进展,总结当前心肾联合移植的适应证、手术方法、围手术期处理、免疫抑制方法、预后及免疫抑制机制等方面的经验,以期为心肾联合移植的发展应用提供参考。随着对心肾联合移植应用规范和免疫抑制机制的理解加深,符合心肾联合移植适应证的患者采用心肾联合移植的生存率往往高于单独心脏移植,同时排斥反应发生率低于单独心脏移植,但心肾联合移植的适应证规范目前仍不完善,尚待进一步研究。Combined heart‑kidney transplantation has become an important treatment for patients with end‑stage heart disease combined with renal failure in recent years,but there is still a lack of perfect standards for the implementation of combined heart‑kidney transplantation in clinic.In this paper,the latest clinical and basic research progress of combined heart‑kidney transplantation in China and abroad were reviewed,and the current experience in indications,surgical methods,perioperative management,immunosuppressive methods,prognosis and immunosuppressive mechanism of combined heart‑kidney transplantation were summarized to provide a reference for the development and application of combined heart‑kidney transplantation.With the deepening understanding on the application specifications of combined heart‑kidney transplantation and immunosuppressive mechanism,the survival rate of patients who meet the indications of combined heart‑kidney transplantation is often higher than that of patients who receive heart transplantation alone.At the same time,the incidence of rejection is lower than that of heart transplantation alone.However,the indication specifications of combined heart‑kidney transplantation are still imperfect and need further study.

关 键 词：心肾联合移植 免疫抑制 适应证 

分 类 号：R654.2[医药卫生—外科学]