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Combined heart-kidney transplantation after total artificial heart insertion

A Ruzza1, L S C Czer2, K A Ihnken1

  • 1Cedars-Sinai Heart Institute, Division of Cardiothoracic Surgery, Cedars Sinai Medical Center, Los Angeles, California, United States.

Transplantation Proceedings
|January 19, 2015
PubMed

Insights

Total artificial heart (TAH) serves as a viable bridge for patients with advanced heart and kidney failure awaiting combined heart and kidney transplantation. This approach successfully restored function in two critical cases.

Area of Science:

  • Cardiology
  • Nephrology
  • Transplantation Medicine

Background:

  • Advanced heart failure and end-stage renal disease present complex clinical challenges.
  • Mechanical circulatory support is crucial for patients awaiting heart transplantation.
  • Combined heart and kidney transplantation is a definitive treatment for combined organ failure.

Observation:

  • Two patients with advanced heart failure and dialysis-dependent renal failure received a total artificial heart (TAH).
  • TAH implantation served as a bridge to combined heart and kidney transplantation in both cases.
  • Both patients experienced successful transplantation with restored cardiac and renal function.

Findings:

  • The total artificial heart (TAH) facilitated successful bridging to combined heart and kidney transplantation.
  • TAH implantation was associated with restored normal heart and kidney function post-transplant.
  • This approach demonstrates the safety and feasibility of TAH in selected patients with combined organ failure.

Implications:

  • Total artificial heart (TAH) is a safe and feasible option for bridging carefully selected patients to combined heart and kidney transplantation.
  • The Freedom driver's FDA approval may enable outpatient management, potentially reducing healthcare costs.
  • TAH's pulsatile flow capability may aid in the recovery of patients with marginal renal function and advanced heart failure.

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