[Multiple organ transplants]

The authors review the literature dealing with heart transplantation in combination with that of other extrathoracic solid organs. Heart-lung transplantation was not considered in this review as it is a well-defined procedure that does not strictly fit the concept of multiorgan transplantation. We present the experience of the first case of heart-liver transplantation involving organs from two different donors reported in the world medical literature. The recipient was a 9-year-old boy with type II homozygous familial hypercholesterolemia. Nine years later, the activity of the patient is normal, as are his liver and heart functions. Our series consists of fours cases of heart-kidney transplantation in patients who were undergoing periodic hemodialysis to treat glomeruloangiosclerosis and presented concomitant end-stage heart disease. On two occasions, both heart and kidney were transplanted during the same surgical procedure with organs from a single donor. The first to be performed was heart transplantation, and the kidney transplantation procedure was undertaken once hemodynamic stability was achieved. The remaining two patients had undergone kidney transplantation two and three years prior to heart transplantation. All the patients are alive, with NYHA class I, and present good ventricular and kidney function. The mean follow-up period is 5 years.