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Mechanical circulatory support as a bridge to combined dual organ transplantation in children
Jeffrey J Kim1, Susan W Denfield, E Dean McKenzie
1Section of Pediatric Cardiology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas 77030, USA. jjkim@texaschildrenshospital.org
Insights
Mechanical circulatory support successfully bridges children with heart and kidney failure to combined heart-kidney transplants. This approach offers a viable option for complex pediatric end-stage organ failure.
Area of Science:
- Cardiology
- Nephrology
- Transplantation Medicine
Background:
- Mechanical circulatory support (MCS) is an established bridge to cardiac transplantation.
- Broadened organ transplantation criteria facilitate multi-organ transplants.
- Pediatric end-stage heart and renal failure present complex therapeutic challenges.
Observation:
- Two pediatric patients with combined end-stage heart and renal failure were treated.
- Mechanical circulatory support was utilized as a bridge therapy for these patients.
Findings:
- Both children were successfully bridged to combined, single-donor heart and kidney transplantation.
- Mechanical circulatory support proved effective in stabilizing patients awaiting complex multi-organ transplants.
Implications:
- This case series highlights the feasibility of MCS in bridging pediatric patients to combined heart-kidney transplantation.
- MCS may expand therapeutic options for children with combined end-stage cardiopulmonary and renal disease.
- Successful combined heart-kidney transplantation following MCS support demonstrates a promising strategy for complex pediatric organ failure.
Abstract:
The use of mechanical circulatory support as a bridge to cardiac transplantation is now an accepted therapeutic option. Also, as the criteria for organ transplantation have broadened, multi-organ transplantation has become more feasible. We report the cases of 2 children with end-stage heart failure and renal failure who were successfully bridged to combined, single-donor heart and kidney transplantation with mechanical circulatory support.
