Combined heart and kidney transplantation provides an excellent survival and decreases risk of cardiac cellular rejection and coronary allograft vasculopathy. Transplant Proc 2011 Jun;43(5):1871-6
Date
06/23/2011Pubmed ID
21693292DOI
10.1016/j.transproceed.2011.01.190Scopus ID
2-s2.0-79959431604 (requires institutional sign-in at Scopus site) 43 CitationsAbstract
BACKGROUND: We analyzed the results of combined heart-kidney transplantation (CHKTx) over a 10-year period.
METHODS: Between September 1996 and May 2007 at Mayo Clinic, 12 patients (age 52 ± 12.2 years) underwent CHKTx as a simultaneous procedure in 10 recipients and as a staged procedure in two recipients with unstable hemodynamics after heart transplantation.
RESULTS: There was no operative mortality. Patient survival rates for the CHKTx recipients at 1 and 3 months and 6 years were 91%, 83%, and 83% and did not differ from isolated heart transplantation (IHTx) recipients (97%, 95%, and 79%, P = 0.61). The freedom from cardiac allograft rejection (≥ grade 2) at 3 months was 73% for CHKTx and had not changed during further follow-up; for IHTx, freedom from rejection at 3 months and 1 and 6 years was 61%, 56%, and 42% (P = .08). Heart and renal allograft survival was 100% with and left ventricular ejection fraction 66% ± 8.4% and glomerular filtration rate 61 ± 25 at last follow-up. There were no signs of cardiac allograft vasculopathy in the CHKTx recipients.
CONCLUSION: CHKTx yields favorable long-term outcome, with a low incidence of cardiac rejection and vasculopathy. Simultaneous CHKTx appears feasible, if hemodynamics is satisfactory. This approach expands the selection criteria for transplantation in patients with coexisting end-stage cardiac and renal disease.
Author List
Raichlin E, Kushwaha SS, Daly RC, Kremers WK, Frantz RP, Clavell AL, Rodeheffer RJ, Larson TS, Stegall MD, McGregor C, Pereira NL, Edwards BSAuthor
Eugenia Raichlin MD Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultCoronary Vessels
Female
Graft Rejection
Heart Transplantation
Humans
Kidney Function Tests
Kidney Transplantation
Male
Middle Aged
Retrospective Studies
Risk Factors
Survival Rate
