Heart Care Info - Heart Disease Prevention & Treatment

Combined heart and kidney transplantation provides an excellent survival and decreases risk of cardiac cellular rejection and coronary allograft vasculopathy.

E Raichlin, SS Kushwaha, RC Daly... - Transplantation ..., 2011 - ... METHODS: Between September 1996 and May 2007 at Mayo Clinic, 12 patients (age 52 12.2 years) underwent CHKTx as a simultaneous procedure in 10 recipients and as a staged procedure in two recipients with unstable hemodynamics after heart transplantation. ...

There was no operative mortality. Patient survival rates for the CHK Tx recipients at 1 and 3 months and 6 years were 91%, 83%, and 83% and did not differ from isolated heart transplantation (IH Tx) recipients (97%, 95%, and 79%, P = 0.61). The freedom from cardiac allograft rejection (≥ grade 2) at 3 months was 73% for CHK Tx and had not changed during further follow-up; for IH Tx, freedom from rejection at 3 months and 1 and 6 years was 61%, 56%, and 42% (P = .08). Heart and renal allograft survival was 100% with and left ventricular ejection fraction 66% ± 8.4% and glomerular filtration rate 61 ± 25 at last follow-up. There were no signs of cardiac allograft vasculopathy in the CHK Tx recipients.

CHK Tx yields favorable long-term outcome, with a low incidence of cardiac rejection and vasculopathy. Simultaneous CHK Tx appears feasible, if hemodynamics is satisfactory. This approach expands the selection criteria for transplantation in patients with coexisting end-stage cardiac and renal disease.