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Updated: Aug 5, 2026

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Published on: July 19, 2007
Successful combined heart and kidney transplantation in a patient with sickle-cell anemia
Vincent Audard1, Philippe Grimbert, Matthias Kirsch
1Department of Nephrology and Transplantation, Henri Mondor Hospital, Université Paris XII, Créteil, France.
Insights
Dual-organ transplantation, combining heart and kidney, is a feasible treatment for sickle-cell disease (SCD) complications. This case study highlights successful management and positive outcomes for SCD patients requiring combined transplants.
Area of Science:
- Cardiology
- Nephrology
- Hematology
Background:
- Sickle-cell disease (SCD) can lead to end-stage heart and renal failure.
- Management strategies for dual-organ transplantation in SCD patients are not well-established.
Observation:
- A 33-year-old male with homozygous SCD underwent combined heart and kidney transplantation due to end-stage organ failure.
- The patient received pre-operative blood transfusions and moderate hypothermic cardiopulmonary bypass.
- Post-operative management included monitoring for rejection and SCD complications.
Findings:
- The combined heart and kidney transplant was successful with limited peri-operative complications.
- The patient experienced one episode of acute heart rejection within 6 months, without renal rejection.
- At 18 months post-surgery, the patient maintained preserved allograft function, with asymptomatic renal artery stenosis and no vaso-occlusive crises or septic events.
- SCD management involved periodic transfusions.
Implications:
- Combined heart and kidney transplantation is a viable option for select SCD patients.
- Meticulous peri- and post-operative care is crucial for successful outcomes in these complex cases.
- This approach offers a potential therapeutic avenue for SCD patients with multi-organ failure.
Abstract:
Little is known about the management of dual-organ transplantation for sickle-cell disease (SCD)-related complications. In this case study, we report the successful outcome of combined heart and kidney transplantation in a patient with SCD. The recipient was a 33-year-old man with homozygous SCD, who developed end-stage heart and renal failure requiring combined heart and kidney transplantation. The patient was managed with pre-operative blood transfusion and moderate hypothermic cardiopulmonary bypass, with limited peri-operative complications. During the first 6 months there was one episode of acute heart rejection without concomitant renal rejection. Eighteen months after surgery, the patient is at home without vaso-occlusive crises or septic complications. Heart and renal allograft function is preserved, without coronary artery vasculopathy, but with asymptomatic moderate transplant renal artery stenosis. SCD is managed by periodic transfusion. This case study demonstrates that combined heart and kidney transplantation is feasible in patients with SCD. Careful attention to peri- and post-operative management is required.
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