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Updated: Jun 23, 2026
Murine Heterotopic Heart Transplant Technique
Published on: July 8, 2014
Long-term results of combined heart and kidney transplantation: a French multicenter study
Emmanuelle Vermes1, Philippe Grimbert, Laurent Sebbag
1Department of Cardiac Surgery, Henri-Mondor University Hospital, Créteil, France.
Insights
Long-term survival after combined heart and kidney transplants is comparable to isolated heart transplants. This large study shows low rates of rejection and coronary artery vasculopathy in heart-kidney recipients.
Area of Science:
- Cardiology
- Nephrology
- Transplantation Immunology
Background:
- Previous studies on combined heart and kidney transplantation outcomes were limited to small, single-center cohorts.
- This study investigates long-term results in a large, multicenter patient population.
Purpose of the Study:
- To evaluate the long-term outcomes of combined heart and kidney transplantation.
- To compare survival rates with those of isolated heart transplantation recipients.
Main Methods:
- A cohort of 67 patients undergoing combined heart and kidney transplantation between 1984 and 2007 across 3 French centers was analyzed.
- Patients received triple immunosuppression therapy, including anti-calcineurin agents, steroids, and azathioprine or mycophenolate.
- Data on survival, rejection rates, and coronary artery vasculopathy were collected.
Main Results:
- Overall actuarial survival rates at 1, 3, 5, and 10 years were 62.0%, 60.3%, 53.3%, and 46.5%, respectively.
- These survival rates were similar to those of 2981 isolated heart recipients during the same period (p = 0.6).
- Kidney graft survival remained high at 95.9% at 10 years, with low rates of acute heart (17.9%) and kidney (13.4%) rejection and coronary artery vasculopathy (9.3%).
Conclusions:
- Long-term survival in combined heart and kidney transplant recipients is comparable to isolated heart transplant recipients in France.
- The study demonstrates low rates of acute rejection for both cardiac and kidney allografts.
- Angiographic coronary artery vasculopathy incidence was also found to be low in this cohort.
Background:
Outcomes in recipients who have undergone combined heart and kidney transplantation have mainly been addressed in small, single-center studies. We studied long-term results of combined heart and kidney transplantation in a large multicenter cohort.
Methods:
Between 1984 and 2007, 67 consecutive patients (61 men and 6 women) from 3 French centers underwent combined heart and kidney transplantation. At transplantation, 38 (57%) were receiving dialysis. All patients received immediate triple immunosuppression therapy (anti-calcineurin, steroids, azathioprine, or mycophenolate).
Results:
Overall actuarial survival rates were 62.0%, 60.3%, 53.3%, and 46.5% at 1, 3, 5, and 10 years, respectively. These rates were similar to those observed in 2981 isolated heart recipients at the 3 participating centers during the same period (respectively, 71.0%, 65.2%, 60.1%, and 47.2%, p = 0.6). Survival tended to improve during the last decade (1996 to 2007) and reached 71.1%, 67.5%, and 60% at 1, 3, and 5 years. Cardiac allograft rejection requiring treatment occurred in 12 (17.9%). Coronary artery vasculopathy developed in 3 (9.3%). Kidney allograft rejection occurred in 9 (13.4%). Kidney graft survival was 95.9% at 1, 3, 5, and 10 years.
Conclusions:
Long-term survival rates in a large cohort of combined heart and kidney recipients are similar to those of isolated heart recipients in France. The rates of acute heart and kidney rejection and angiographic coronary artery vasculopathy were low in this patient population.
