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Combined heart-kidney transplantation: the University of Wisconsin experience

Joshua L Hermsen1, Dilip S Nath, Alejandro Munoz del Rio

  • 1Division of Cardiothoracic Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53791-7375, USA. hermsen@surgery.wisc.edu

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
|November 21, 2007
PubMed

Insights

Combined heart-kidney transplantation (HKTx) shows survival rates comparable to single-organ transplants. This approach may offer an immunologic advantage, warranting further investigation for optimal recipient selection.

Area of Science:

  • Transplantation Medicine
  • Immunology
  • Cardiology
  • Nephrology

Background:

  • Combined heart-kidney transplantation (HKTx) is a growing procedure.
  • Long-term outcomes and comparative analyses for HKTx are limited.

Purpose of the Study:

  • To compare long-term outcomes of HKTx with single-organ heart or kidney transplantation.
  • To evaluate patient and graft survival, rejection rates, and coronary allograft vasculopathy (CAV) in HKTx recipients.

Main Methods:

  • Retrospective review of prospectively collected data from 19 HKTx patients.
  • Comparison of HKTx outcomes against heart-only (n=515), kidney-only (n=3,188), and simultaneous separate transplants (n=8).
  • Analysis included patient/graft survival, rejection episodes, and CAV incidence.

Main Results:

  • No significant difference in patient or graft survival between HKTx and control groups.
  • Significantly prolonged time to first rejection episode for both organs in HKTx compared to single-organ recipients.
  • Significantly lower incidence of coronary allograft vasculopathy (CAV) in HKTx patients.

Conclusions:

  • HKTx demonstrates outcomes similar to solitary heart or kidney transplantation.
  • Combined organ transplantation may confer an immunologic advantage.
  • While medically appropriate, refined strategies are needed to identify optimal HKTx recipient populations.
Abstract

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