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Pediatric Combined Heart-liver Transplantation: A Single-center Long-term Experience
Steven Levitte1, Riya Nilkant2, Sharon Chen3
1Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Stanford University, Palo Alto, CA.
Transplantation Direct
|August 21, 2024
Summary
Combined heart liver transplant (CHLT) is a rare but viable option for pediatric patients with severe heart and liver disease. Long-term follow-up shows successful outcomes, suggesting CHLT should be considered more often.
Area of Science:
- Cardiology
- Hepatology
- Transplant Surgery
Background:
- Combined heart liver transplant (CHLT) is an emerging surgical option for patients with advanced heart and liver disease.
- Despite its potential, CHLT remains a rare procedure.
Purpose of the Study:
- To evaluate the long-term outcomes of pediatric patients who underwent combined heart liver transplant.
- To assess the feasibility and success rates of CHLT in a young patient population.
Main Methods:
- A retrospective review of 7 pediatric patients (ages 7-17) who underwent CHLT between January 1, 2010, and December 31, 2023.
- Analysis of patient data including pre-transplant conditions, surgical procedures, and post-transplant complications, with follow-up up to 14 years.
Main Results:
- 14.3% 30-day mortality due to multiorgan failure.
- Rejection episodes (acute heart and liver) occurred but were successfully treated; no chronic or refractory rejection was observed.
- No instances of allograft coronary artery vasculopathy were reported.
Conclusions:
- Combined heart liver transplant is a feasible treatment for pediatric patients with end-stage heart and liver disease.
- Long-term data support considering CHLT more frequently for eligible pediatric candidates.
