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.

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