BACKGROUND: Combined heart-kidney transplantation (HKTx) is increasing in frequency, but long-term outcomes are unknown and appropriately comparative analysis is lacking. METHODS: This study was a retrospective review of prospectively collected data for 19 HKTx patients. Patient and graft survival, graft rejection and coronary allograft vasculopathy (CAV) were compared for HKTx vs recipients of a heart (n = 515) or kidney alone (n = 3,188) or both organs at separate time-points (n = 8). RESULTS: Patient and graft survival did not differ for HKTx vs any group. HKTx time to first rejection episode was significantly prolonged for both organs vs single-organ recipients. The incidence of CAV was significantly lower for HKTx. CONCLUSIONS: HKTx provides outcomes similar to those for solitary heart or kidney transplantation. There may be an immunologic advantage to receiving organs in a combined fashion. Such allocation of organs seems medically appropriate; however, more refined strategies are needed to identify optimal recipient populations.
BACKGROUND: Combined heart-kidney transplantation (HKTx) is increasing in frequency, but long-term outcomes are unknown and appropriately comparative analysis is lacking. METHODS: This study was a retrospective review of prospectively collected data for 19 HKTx patients. Patient and graft survival, graft rejection and coronary allograft vasculopathy (CAV) were compared for HKTx vs recipients of a heart (n = 515) or kidney alone (n = 3,188) or both organs at separate time-points (n = 8). RESULTS:Patient and graft survival did not differ for HKTx vs any group. HKTx time to first rejection episode was significantly prolonged for both organs vs single-organ recipients. The incidence of CAV was significantly lower for HKTx. CONCLUSIONS: HKTx provides outcomes similar to those for solitary heart or kidney transplantation. There may be an immunologic advantage to receiving organs in a combined fashion. Such allocation of organs seems medically appropriate; however, more refined strategies are needed to identify optimal recipient populations.
Authors: Makoto Tonsho; Sebastian Michel; Zain Ahmed; Alessandro Alessandrini; Joren C Madsen Journal: Cold Spring Harb Perspect Med Date: 2014-05-01 Impact factor: 6.915
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Authors: Jill Savla; Kimberly Y Lin; Madhura Pradhan; Rebecca L Ruebner; Rachel S Rogers; Somaly S Haskins; Anjali T Owens; Peter Abt; J William Gaynor; Robert E Shaddy; Joseph W Rossano Journal: J Am Heart Assoc Date: 2015-12-11 Impact factor: 5.501