http://circ.ahajournals.org/cgi/content/abstract/121/25/2733

Survival of Kidney Transplantation Patients in the United States After Cardiac Valve Replacement
Alok Sharma, MD; David T. Gilbertson, PhD; Charles A. Herzog, MD
From the Department of Internal Medicine, Hennepin County Medical Center, University of Minnesota, Minneapolis (A.S., C.A.H.), and Cardiovascular Special Studies Center, United States Renal Data System, Minneapolis Medical Research Foundation, Minneapolis, Minn (D.T.G., C.A.H.).

Received September 25, 2009; accepted April 30, 2010.

Background— Few published studies address the survival of kidney transplantation patients after valve surgery, and none address relative outcomes related to tissue versus nontissue prosthesis. This study aimed to assess survival of US kidney transplantation patients after cardiac valve replacement and to compare associations of valve selection.

Methods and Results— Of 1 698 706 patients in the US Renal Data System database, we identified 1335 kidney transplantation patients hospitalized in 1991 to 2004 for cardiac valve replacement. Survival was estimated by the Kaplan-Meier method; independent predictors of death were examined in a comorbidity-adjusted (by Charlson and propensity score) Cox model. Of the cohort, 17% were 0 to 44 years of age, 50% were 45 to 64 years of age, 28% were 65 to 74 years of age, and 5% were 75 years of age; 78% were white; 63% were men; and 20% had kidney failure caused by diabetes mellitus. Of 369 patients (28%) who received tissue valves, 75% had aortic valve replacement, 20% had mitral valve replacement, and 5% had both. Use of tissue valves increased from 13% in 1991 to 1995 to 38% in 2000 to 2004. Age, diabetes mellitus, and combined aortic and mitral valve replacement were the strongest predictors of all-cause mortality. In-hospital mortality was 14.0% overall, 11.4% for tissue-valve patients, and 15.0% for nontissue-valve patients (P=0.09). Two-year survival estimates were 61.5% for tissue-valve and 59.5% for nontissue-valve patients (P=0.30). The adjusted hazard ratio of death for tissue- versus nontissue-valve patients was 0.83 (95% confidence interval, 0.70 to 0.99).

Conclusions— Renal transplantation patients requiring valve replacement have high mortality rates (20%/y). These data suggest minimally reduced mortality risk for patients receiving tissue versus nontissue valves.

Я специально подчеркнул основные моменты.Я помню,что по английский у вас хороший,и вам не нужно переводить. Это статистика Америки.
В других странах статистика смертности еще выше.Даже если вам посчастливится,не попадете в те американских 20% , и вы выпишитесь из больницы -как вести вас потом. Вы будете на постоянной иммуносупрессивной терапии.Любая инфекция у человека с искусственным
клапаном может привести к бактериальному эндокардиту.И если микроб сел на клапан - то это крайне и крайне плохо. Это длительные госпитализации с многонедельными курсами антибактериальной терапии.
Мне видится- что ваша затея насчет трансплантации крайне опасная,рискованная и скорее всего неоправданная.
С удовольствием послушаю другие мнения.

Недавно был оперирован один из моих бывших пациентов (просто он сейчас на диализе в другом центре), молодой человек, которому был заменен один клапан и выполнена пластика другого... сейчас он чувствует себя хорошо. Стал задумываться о трансплантации. Не знаю, не знаю.. боязно как-то...