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Combined Heart and Kidney Transplantation: Initial Clinical Experience
Fernando Antibas Atik1, Carolina de Castro Borges2, Marcelo Botelho Ulhoa2
1Department of Cardiovascular Surgery, Instituto de Cardiologia do Distrito Federal, Brasília, Federal District, Brazil.
Insights
Combined heart and kidney transplants in Brazil showed favorable outcomes in selected patients with advanced heart failure and end-stage kidney disease. A multidisciplinary team approach is crucial for successful combined organ transplantation.
Area of Science:
- Cardiology
- Nephrology
- Transplantation Medicine
Background:
- Combined solid organ transplantation is rarely performed in Brazil.
- Advanced heart failure and end-stage kidney disease often require complex treatment strategies.
Purpose of the Study:
- To present the initial experience with combined heart and kidney transplantation in Brazil.
- To evaluate the feasibility and outcomes of this procedure in a select patient group.
Main Methods:
- Four patients underwent combined heart and kidney transplantation between January 2007 and December 2019.
- All patients had Chagas cardiomyopathy and were on preoperative dialysis.
Main Results:
- All four patients survived with a mean follow-up of 34.7 months, achieving New York Heart Association functional class I.
- Mean delayed kidney graft function was 22.9 days; one patient lost the kidney graft due to infection.
- The procedure demonstrated favorable short-term outcomes in this cohort.
Conclusions:
- Combined heart and kidney transplantation can be a successful option for carefully selected patients.
- A dedicated multidisciplinary team is essential for managing these complex cases.
Introduction:
Combined solid organ transplantation is infrequently performed in Brazil. The objective of this article is to present our initial experience with combined heart and kidney transplantation.
Methods:
From January 2007 to December 2019, four patients were submitted to combined heart and kidney transplantation. Their mean age was 55.7±4.4 years, and three (75%) patients were males. All patients had Chagas cardiomyopathy, two were hospitalized and inotrope dependent, and all patients were on preoperative dialysis (median of 12 months prior to transplant).
Results:
All patients survived and were in New York Heart Association functional class I at the latest follow-up (mean 34.7±17.5 months). Mean retarded kidney graft function was 22.9±9.7 days. One patient lost the kidney graft two years after the transplant due to Polyomavirus infection.
Conclusion:
Our initial experience of combined heart and kidney transplantation was favorable in selected patients with advanced heart failure and end-stage kidney disease. It requires involvement of a dedicated multispecialty team throughout all the diagnostics and treatment steps.
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