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Combined heart and kidney transplantation using a single donor: a single center's experience with nine cases
A A Kocher1, B Schlechta, C W Kopp
1Department of Surgery, University of Vienna, Vienna General Hospital, Austria.
Insights
Simultaneous heart and kidney transplantation (HNTX) is a viable option for patients with advanced heart and kidney failure. Careful patient selection and separate organ rejection monitoring are crucial for successful outcomes.
Area of Science:
- Transplantation immunology
- Cardiovascular surgery
- Nephrology
Background:
- Simultaneous double-organ transplants are increasingly common.
- This study details a single center's experience with heart and kidney transplantation (HNTX).
- Focus is placed on patient selection and outcomes.
Purpose of the Study:
- To report on the experience of simultaneous heart and kidney transplantation (HNTX).
- To emphasize the selection criteria used for HNTX.
- To evaluate patient outcomes following HNTX.
Main Methods:
- Nine patients underwent HNTX between September 1990 and January 1997.
- Grafts were from single donors, matched for ABO blood group and negative crossmatch.
- HLA-antigen matching was not a selection criterion.
Main Results:
- Eight of nine patients survived with normal cardiac and renal function at a mean follow-up of 44 months.
- One patient experienced early acute humoral rejection of the cardiac graft.
- Independent rejection episodes occurred for each organ.
Conclusions:
- HNTX is a promising treatment for combined advanced cardiac and renal failure in selected patients.
- Separate rejection surveillance for heart and kidney grafts is recommended.
- Careful patient selection is key to successful HNTX outcomes.
Background:
Simultaneous double-organ transplants comprising various organ combinations have become frequent. The purpose of this article is to report on a single center's experience of simultaneous heart and kidney transplantation (HNTX) with particular emphasis on selection criteria and patient outcome.
Methods:
From September 1990 to January 1997, nine patients underwent HNTX, receiving both grafts from a single donor selected on ABO blood group compatibility and a negative lymphocytotoxic crossmatch, but without regard to HLA-antigen matching.
Results:
One patient died of acute humoral rejection of the cardiac graft shortly after surgery. Eight patients are alive and well and have normal cardiac and renal function at a mean follow-up of 44+/-28 months.
Conclusion:
HNTX offers a compelling therapeutic solution in the treatment of advanced cardiac and renal failure in carefully selected patients. Because the heart and kidney rejection episodes were independent of each other, rejection surveillance should be carried out separately for each transplanted organ.