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Combined Heart-kidney Transplantation: A Single Center Experience

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DOI: 10.4236/ojots.2011.12003    3,514 Downloads   8,025 Views   Citations

ABSTRACT

Introduction: We report our experience with seven cases of combined heart-kidney transplantation (HKT). Patients and methods: Between January 2003 and December 2009, seven subjects underwent combined HKT, receiving both organs from a single donor. Their age ranged from 30 years to 59 years, six were male. Five patients were dialysis dependent before transplantation and two were in chronic renal failure (serum creatinine levels > 2.6 mg/dL). The heart was transplanted first in all cases. Results: Heart function rapidly re-covered in five of the patients, while two needed temporary inotropic and mechanical support. Diuresis started immediately in four patients. At discharge, all patients had well-functioning grafts (left ventricular ejection fraction 60% ± 6%; serum creatinine 1.4 ± 0.3 mg/dL). After an average follow-up period of 45 ± 24 months no deaths have occurred. Heart allografts are functioning normally in six patients and none of the patients currently require dialysis treatment. The main adverse event noted during follow-up was hypertension in five patients. Four patients were cardiac allograft rejection free and five patients were kidney rejection free. Conclusion: Our results are in line with the data which has been previously reported in the literature and suggest that HKT is a viable therapeutic choice in the treatment of advanced cardiac and renal failure in carefully selected patients.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Bacchi, G. , Potena, L. , Mosconi, G. , Quarta, C. , Stalteri, L. , Magnani, G. , Feliciangeli, G. , Grigioni, F. , Branzi, A. and Stefoni, S. (2011) Combined Heart-kidney Transplantation: A Single Center Experience. Open Journal of Organ Transplant Surgery, 1, 14-18. doi: 10.4236/ojots.2011.12003.

References

[1] J. Norman, D. Cooley, B., Kahan, et al., “Total Support of the Circulation of a Patient with Post-Cardiotomy Stone-Heart Syndrome by a Partial Artificial Heart (ALVAD) for 5 Days Followed by Heart and Kidney Transplantation,” Lancet, Vol. 1, No. 8074 , 1978, pp. 1125-1127. doi:10.1016/S0140-6736(78)90301-X
[2] S. Livesey, K. Rolles, R. Calne, J. Wallwork and T. A. H. English, “Successful Simultaneous Heart and Kidney Transplantation Using the Same Donor,” Clinical Transplantation, Vol. 2, 1988, pp. 1-4.
[3] J. Narula, L. E. Bennett, T. DiSalvo, J. D. Hosenpud, M. J. Semigran and G. W. Dec, “Outcomes in Recipients of Combined Heart-Kidney Transplantation: Multiorgan, Same-Donor Transplant Study of the International Society of Heart and Lung Transplantation/United Network for Organ Sharing Scientific Registry,” Transplantation, Vol. 63, No. 6, 1997, pp. 861-867. doi:10.1097/00007890-199703270-00012
[4] G. D. Trachiotis, J. D. Vega, T. S. Johnston, et al., “Ten-Year Follow-up in Patients with Combined Heart and Kkidney Transplantation,” Journal of Thoracic and Cardiovascular Surgery, Vol. 126, No. 6, 2003, pp. 2065-2071. doi:10.1016/j.jtcvs.2003.07.009
[5] S. S. Wang, N. K. Chou, N. H. Chi, et. al., “Simultaneous Heart and Kidney Transplantation for Combined Cardiac and Renal Failure,” Transplantation Proceedings, Vol. 38, No. 7, 2006, pp. 2135-2137. doi:10.1016/j.transproceed.2006.06.002
[6] J. L. Hermsen, D. S. Nath, A. M. del Rio, J. B. Eickstaedt, C. Wigfield, J. D. Lindsey and N. M. Edwards, “Com-bined Heart-Kidney Transplantation: The University of Wisconsin Experience,” Journal of Heart and Lung Transplantation, Vol. 26, No. 11, 2007; pp. 1119-1126. doi:10.1016/j.healun.2007.08.011
[7] G. Bruschi, L. Botta, T. Colombo, et al., “Combined Heart and Kidney Transplantation: Long-Term Analysis of Renal Function and Major Adverse Events at 20 Years,” Transplantation Proceedings, Vol. 42, No. 4, 2010, pp. 1283-1285. doi:10.1016/j.transproceed.2010.03.064
[8] M. J. Russo, A. Rana, J. M. Chen, et al., “Pretransplantation Patient Characteristics and Survival Following Combined Heart and Kidney Transplantation,” Archives of Surgery, Vol. 144, No. 3, 2009, pp. 241-246. doi:10.1001/archsurg.2008.559
[9] C. Blanche, A. Kamlot, D. A. Blanche, B. Kearney, A. V. Wong, L. S. Czer and A. Trento, “Combined Heart-Kidney Transplantation with Single-Donor Allografts,” Jour- nal of Thoracic and Cardiovascular Sur-gery, Vol. 122, No. 3, 2001, pp. 495-500. doi:10.1067/mtc.2001.115700
[10] W. D. Irish, D. A. McCollum, R. J. Tesi, et al., “Nomo-gram for Predicting the Likelihood of Delayed Graft Function in Adult Cadaveric Renal Transplant Recipients,” Journal of the American Society of Nephrology, Vol. 14, No. 11, 2003, pp. 2967-2974. doi:10.1097/01.ASN.0000093254.31868.85
[11] S. G. Yarlagadda, S. G. Coca, R. N. Formica Jr, E. D. Poggio and C. R. Parikh, “Association between Delayed Graft Function and Allograft and Patient Survival: A Systematic Review and Meta-Analysis,” Nephrology Di-alysis Transplantation, Vol. 24, No. 3, 2009, pp. 1039-1047. doi:10.1093/ndt/gfn667
[12] A. Rana, S. Robles, M. J. Russo, et al., “The Combined Organ Effect: Protection against Rejection?” Annals of Surgery, Vol. 248, No. 5, 2008, pp. 871-879. doi:10.1097/SLA.0b013e31817fc2b8
[13] T. E. Starzl, A. J. Demetris, N. Murase, et al., “Chimerism after Organ Transplantation,” Current Opinion in Nephrology and Hypertension, Vol. 6, No. 3, 1997, pp. 292-298. doi:10.1097/00041552-199705000-00015
[14] N. Perico and G. Remuzzi, “Acquired Transplant Tolerance,” International Journal of Clinical and Laboratory Research, Vol. 27, No. 3, 1997, pp. 165-177. doi:10.1007/BF02912453
[15] J. A. Castillo-Lugo and K. R. Brinker, “An Overview of Combined Heart and Kidney Transplantation,” Current Opinion in Cardiolog, Vol. 14, No. 2, 1999, pp. 121-125. doi:10.1097/00001573-199903000-00008
[16] N. R. Banner, C. A. Rogers and R. S. Bonser, United Kingdom Cardiothoracic Transplant Audit Steering Group, “Effect of Heart Transplantation on Survival in Ambulatory and Decompensated Heart Dailure,” Transplantation, Vol. 86, No. 11, 2008, pp. 1515-1522. doi:10.1097/TP.0b013e31818b3328
[17] G. Mosconi, L. Panicali, E. Persici, et al., “Native Kidney Function after Renal Transplantation Combined with Other Solid Organs in Preemptive Patients,” Transplantation Proceedings, Vol. 42, No. 4, 2010, pp. 1017-1020. doi:10.1016/j.transproceed.2010.03.125

  
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