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Identifying Predictors of Outcomes in Combined Heart and Liver Transplantation

Suzie Lee1, Lea Matsuoka1, Shu Cao2

  • 1Division of Hepatobiliary Surgery and Liver Transplantation, Vanderbilt University, Nashville, TN, USA.

Transplantation Proceedings
|June 23, 2019
PubMed

Insights

Combined heart and liver transplants (CHLT) show acceptable survival rates. Diabetes increases graft failure risk, while the post-2006 era improved outcomes, highlighting the need for ongoing assessment of selection criteria.

Area of Science:

  • Transplantation Medicine
  • Cardiovascular Surgery
  • Hepatology

Background:

  • Combined heart and liver transplant (CHLT) is a complex procedure with increasing frequency.
  • Graft and patient outcomes, along with risk factors for survival, require further investigation due to the procedure's rarity.

Purpose of the Study:

  • To assess graft and patient survival rates after CHLT.
  • To identify risk factors associated with graft failure and patient mortality in CHLT recipients.

Main Methods:

  • Retrospective analysis of the United Network for Organ Sharing database from 1989 to 2014.
  • Evaluation of graft and patient survival at 1, 3, and 5 years post-transplant.
  • Multivariable Cox proportional hazard models were used to determine risk factors.

Main Results:

  • The study included 186 patients, with 1, 3, and 5-year graft and patient survival rates of 85%, 77%, and 74%, respectively.
  • Diabetes was significantly associated with an increased risk of graft failure and patient mortality (HR [95% CI]: 2.28 [1.05, 4.92]; P = .036).
  • The period after 2006 demonstrated significantly improved graft and overall survival (HR [95% CI]: 0.45 [0.24, 0.87]; P = .017).

Conclusions:

  • Combined heart and liver transplant can achieve acceptable outcomes with careful patient selection.
  • Continuous assessment of outcomes and selection criteria is essential as CHLT procedures become more common.
Abstract

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