Abstract:
Patients with end-stage heart disease who undergo a heart transplant frequently have simultaneous kidney insufficiency, therefore simultaneous heart and kidney transplantation is an option and it is necessary to understand its characteristics and long-term variables. The recipient characteristics and operative and long-term variables were assessed in a meta-analysis. A total of 781 studies were screened, and 33 were thoroughly reviewed. 15 retrospective cohort studies and 376 patients were included. The recipient\'s mean age was 51.1 years (95% CI 48.52-53.67) and 84% (95% CI 80-87) were male. 71% (95% CI 59-83) of the recipients were dialysis dependent. The most common indication was ischemic cardiomyopathy [47% (95% CI 41-53)] and cardiorenal syndrome [22% (95% CI 9-35)]. Also, 33% (95% CI 20-46) of the patients presented with delayed graft function. During the mean follow-up period of 67.49 months (95% CI 45.64-89.33), simultaneous rejection episodes of both organ allografts were described in 5 cases only. Overall survival was 95% (95% CI 88-100) at 30 days, 81% (95% CI 76-86) at 1 year, 79% (95% CI 71-87) at 3, and 71% (95% CI 59-83) at 5 years. Simultaneous heart and kidney transplantation is an important option for concurrent cardiac and renal dysfunction and has acceptable rejection and survival rates.
摘要:
接受心脏移植的终末期心脏病患者经常同时出现肾功能不全,因此,同时进行心脏和肾脏移植是一种选择,有必要了解其特征和长期变量。在荟萃分析中评估了接受者的特征以及手术和长期变量。共筛选了781项研究,33人被彻底审查。纳入15项回顾性队列研究和376例患者。受者的平均年龄为51.1岁(95%CI48.52-53.67),84%(95%CI80-87)为男性。71%(95%CI59-83)的受者依赖透析。最常见的适应症是缺血性心肌病[47%(95%CI41-53)]和心肾综合征[22%(95%CI9-35)]。此外,33%(95%CI20-46)的患者出现移植功能延迟。在67.49个月的平均随访期内(95%CI45.64-89.33),仅在5例中描述了两种器官同种异体移植物的同时排斥反应。30天的总生存率为95%(95%CI88-100),81%(95%CI76-86),3年为79%(95%CI71-87),5年为71%(95%CI59-83)。同时进行心脏和肾脏移植是并发心脏和肾功能不全的重要选择,并且具有可接受的排斥反应和生存率。