关键词: 心肾联合移植 , 终末期心脏病 , 终末期肾病 , 围手术期管理 , 随访管理

Abstract:

Objective This article aims to systematically review the domestic and international research status of simultaneous heart-kidney transplantation（SHKT），and explore the core key points of recipient selectionand evaluation，perioperative management and long-term postoperative follow-up. Methods A retrospective analysis was conducted on the characteristics of SHKT cases performed at Zhongnan Hospital of Wuhan University between January 2021 and December 2025. Combined with a review of the literature，the diagnostic and therapeutic experience for SHKT was summarized. Results A total of 3 cases of SHKT were included. All three recipients were male，with dilated cardiomyopathy and chronic renal insufficiency as the primary diseases，and were dependent on regular dialysis preoperatively. The surgical procedure involved immediate kidney transplantation following heart transplantation. Immunosuppressive induction was performed using either anti-thymocyte globulin（ATG）orbasiliximab，while the maintenance regimen consisted of tacrolimus，mycophenolate mofetil，and corticosteroids. The donor heart and kidney cold ischemic time were 127.33 min and 510.67 min，respectively. One patient developed delayed graft function postoperatively and required continuous renal replacement therapy（CRRT）. One patient diedon postoperative day 66 due to a concurrent infection with Enterobacter aerogenes and Pseudomonas aeruginosa，the remaining two patients have had favorable outcomes and remain alive to date. Conclusion Simultaneousheart-kidney transplantation is an effective treatment for end-stage heart disease with irreversible renal failure，demonstrating good short-，medium-，and long-term prognoses. Close collaboration within a multidisciplinary team，individualized immunosuppressive regimens，and a deep understanding of heart-kidney interactions are crucial forimproving graft and patient survival rates. 

Key words:

"> Simultaneous heart-kidney transplantation ； End-stage heart disease ； End-stage renal disease； Perioperative management； Follow-up management