Simultaneous heart and kidney transplantation for combined cardiac and renal failure
Journal
Transplantation proceedings
Journal Volume
38
Journal Issue
7
Pages
2135
Date Issued
2006-09
Author(s)
Abstract
Simultaneous heart and kidney transplantation (SHKT) is feasible for combined cardiac and renal failure. Herein we reviewed our 10-year experience in SHKT. Six patients underwent SHKT from June 1995 to December 2004. Their ages ranged from 13 to 63 years old with a mean of 45.5 +/- 15.8 years. They were all men except one girl, who was the youngest (aged 13) who suffered from dilated cardiomyopathy with congestive heart failure and chronic renal failure due to systemic lupus erythematosus. Because of aggravating heart failure, she changed from hemodialysis to peritoneal dialysis. Because of intractable heart failure, she underwent SHKT from a 24-year-old female donor. All received hemodialysis before SHKT. The indications for heart transplantation included dilated cardiomyopathy (n = 3), ischemic cardiomyopathy (n = 1), cardiac allograft vasculopathy (n = 1), and cardiac allograft failure (n = 1). The immunosuppressive protocol and rejection surveillance were these employed for heart transplantation. No operative mortality was noted in this study. The 1-year and 5-year survival rates were the same, 83%. The 10-year survival rate was 55%. No cardiac or renal allograft rejection was noted. No renal allograft loss was noted. There were two late mortalities: the one, who underwent redo heart transplantation for coronary artery vasculopathy died of cardiac allograft failure 1 year after SHKT. The other patient died of massive ischemic necrosis of the intestine at 6 years after SHKT. Our experience showed that SHKT had good short- and long-term results without increasing immunosuppressive doses. End-stage failure of either the heart or the kidney did not preclude heart plus kidney transplantation.
SDGs
Other Subjects
azathioprine; calcineurin inhibitor; creatinine; cyclosporin; immunosuppressive agent; methylprednisolone; mycophenolic acid 2 morpholinoethyl ester; prednisolone; tacrolimus; thymocyte antibody; adolescent; adult; article; cardiac allograft vasculopathy; cardiac graft rejection; chronic kidney failure; clinical article; congestive cardiomyopathy; congestive heart failure; female; graft rejection; heart failure; heart transplantation; hemodialysis; human; immunosuppressive treatment; intestine necrosis; ischemic heart disease; kidney allograft rejection; kidney failure; kidney graft rejection; kidney transplantation; lupus erythematosus; male; mortality; peritoneal dialysis; postoperative complication; priority journal; survival rate; treatment outcome; Adult; Female; Heart Failure, Congestive; Heart Transplantation; Humans; Kidney Failure, Chronic; Kidney Transplantation; Male; Renal Dialysis; Retrospective Studies; Transplantation, Homologous; Treatment Outcome
Publisher
ELSEVIER SCIENCE INC
Type
journal article