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Combined heart and kidney transplantation: what is the appropriate surgical sequence?

Andrea Ruzza1, Lawrence S C Czer, Alfredo Trento

  • 1Division of Cardiothoracic Surgery, Cedars Sinai Medical Center, Los Angeles, CA 90048, USA. andrea.ruzza@cshs.org

Interactive Cardiovascular and Thoracic Surgery
|April 26, 2013
PubMed

Insights

Combined heart and kidney transplants show similar survival and rejection rates to heart transplants alone. A staged surgical approach is recommended for these complex procedures.

Area of Science:

  • Cardiology
  • Nephrology
  • Transplantation Medicine

Background:

  • Combined heart and kidney transplantation is becoming more common.
  • There is a lack of established guidelines for indications, contraindications, and surgical sequencing.

Purpose of the Study:

  • To evaluate the outcomes of combined heart and kidney transplantation compared to heart transplantation alone.
  • To assess the safety and efficacy of combined heart and kidney transplantation.

Main Methods:

  • Single-centre retrospective analysis of 30 consecutive patients undergoing combined heart and kidney transplant.
  • Comparison of outcomes with a cohort of patients who underwent heart transplant alone.

Main Results:

  • Patients in both groups had similar preoperative characteristics.
  • Combined heart and kidney transplant demonstrated comparable long-term survival rates.
  • Low rates of cellular rejection and antibody-mediated rejection were observed in the combined transplant group.
  • No significant differences in outcomes were noted based on preoperative patient characteristics.

Conclusions:

  • Combined heart and kidney transplantation is a viable option with outcomes similar to heart transplantation alone.
  • The staged surgical approach is suggested as the preferred method for combined heart and kidney transplantation.

Keywords:
Combined heart and kidney transplantHeart transplantKidney transplant

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