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

摘要：

目的 系统回顾心肾联合移植的国内外现状，探讨心肾联合移植的受者选择与评估、围手术期管理及术后长期随访的核心要点。 方法 回顾性分析武汉大学中南医院 2021 年 1 月至 2025 年 12 月期间完成的心肾联合移植病例特点，结合文献报道，总结心肾联合移植的诊治经验。 结果 共纳入心肾联合移植 3 例。3 位患者均为男性，原发病为扩张型心肌病伴慢性肾功能不全，术前依赖规律透析治疗，手术方式为心脏移植后立即肾脏移植，采用抗胸腺细胞球蛋白或巴利昔单抗行免疫诱导、他克莫司 + 吗替麦考酚酯 + 泼尼松行抗排斥反应治疗，供心和供肾缺血时间分别为 127.33 min 和 510.67 min。1 例患者术后合并移植肾功能延迟恢复使用 CRRT 治疗，1 例患者因合并产气肠杆菌及铜绿假单胞菌感染在术后 66 d 死亡，2 例患者预后良好、存活至今。 结论 心肾联合移植是治疗终末期心脏病伴不可逆肾功能衰竭的有效手段，近中远期预后均良好。多学科团队的紧密协作、精准的免疫抑制方案以及对心肾交互作用的深刻理解，是提高移植物与患者存活率的关键。

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