心臟移植病患腎功能不全之處置

心臟移植是目前末期心臟衰竭最有效的治療方式。心臟移植術後病患須終生使用免疫抑制藥物以避免排斥發生，因此相伴而來的腎功能不全就成為移植術後常見的問題。本文簡述心臟移植腎臟功能不全的情形，增加臨床醫護人員對此議題之瞭解，能找出需要篩檢與介入的高危險群，提供適當醫療或及早轉介，能延緩腎臟功能的惡化，提昇心臟移植術後的照護品質。

Renal insufficiency after heart transplantation (HTx) is a frequently observed comorbidity. In the current era of prolonged survival after HTx, non-cardiac long-term complications, particularly renal insufficiency, have increasingly become significant determinants of mortality. In this paper, we review the main information on the clinical relevance of renal insufficiency after HTx, as well as the risk factor for the development of renal insufficiency after HTx. We also discuss the currently available experience with renal-sparing immunosuppressive regimens. We hope by increasing public understanding of renal insufficiency after HTx, care guidelines and supportive systems will be developed to enhance the quality of this population.