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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.
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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