BACKGROUND: Simultaneous combined orthotopic heart and liver transplantation (CHLTx) remains a lifesaving procedure for the patients suffering from coincident end-stage heart and liver disease and several metabolic disorders. We analyze the long-term outcome of the patients undergoing CHLTx. METHODS: Between January 1992 and May 2007, 15 CHLTx were attempted at the Mayo Clinic including two combined heart, liver, and kidney transplantations and one combined heart, lung, and liver transplantations. Pretransplant cardiac diagnoses were familial amyloidosis (11), hemochromatosis (1), restrictive cardiomyopathy and cardiac cirrhosis (1), previously operated congenital heart disease and cardiac cirrhosis (1), and primary pulmonary hypertension with primary biliary cirrhosis (1). RESULTS: Heart and liver transplantation were performed as a single combined procedure in 13 (93%) hemodynamically stable patients, and there was no perioperative mortality. Survival rates for the CHLTx recipients at 1 year, 5 years, and 10 years were 100%, 75%, and 60%, respectively, and did not differ from survival after isolated heart transplantation (93%, 83%, and 65%, respectively, P=0.39). Freedom from cardiac allograft rejection (ISHLT > or =grade 2) for CHLTx was 83% at 1 month, did not change with time, and was lower than after isolated heart transplantation (P=0.02). At the mean follow-up of 61.6+/-53.6 months, normal left ventricular ejection fraction and good liver allograft function were demonstrated. Three patients developed end-stage renal failure secondary to calcineurin nephrotoxicity. CONCLUSION: Simultaneous heart and liver transplantation is feasible and achieved excellent results for selected patients.
BACKGROUND: Simultaneous combined orthotopic heart and liver transplantation (CHLTx) remains a lifesaving procedure for the patients suffering from coincident end-stage heart and liver disease and several metabolic disorders. We analyze the long-term outcome of the patients undergoing CHLTx. METHODS: Between January 1992 and May 2007, 15 CHLTx were attempted at the Mayo Clinic including two combined heart, liver, and kidney transplantations and one combined heart, lung, and liver transplantations. Pretransplant cardiac diagnoses were familial amyloidosis (11), hemochromatosis (1), restrictive cardiomyopathy and cardiac cirrhosis (1), previously operated congenital heart disease and cardiac cirrhosis (1), and primary pulmonary hypertension with primary biliary cirrhosis (1). RESULTS: Heart and liver transplantation were performed as a single combined procedure in 13 (93%) hemodynamically stable patients, and there was no perioperative mortality. Survival rates for the CHLTx recipients at 1 year, 5 years, and 10 years were 100%, 75%, and 60%, respectively, and did not differ from survival after isolated heart transplantation (93%, 83%, and 65%, respectively, P=0.39). Freedom from cardiac allograft rejection (ISHLT > or =grade 2) for CHLTx was 83% at 1 month, did not change with time, and was lower than after isolated heart transplantation (P=0.02). At the mean follow-up of 61.6+/-53.6 months, normal left ventricular ejection fraction and good liver allograft function were demonstrated. Three patients developed end-stage renal failure secondary to calcineurin nephrotoxicity. CONCLUSION: Simultaneous heart and liver transplantation is feasible and achieved excellent results for selected patients.
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
Authors: Eliza W Beal; Khalid Mumtaz; Don Hayes; Bryan A Whitson; Sylvester M Black Journal: Transplant Rev (Orlando) Date: 2016-07-17 Impact factor: 3.943
Authors: Yan Topilsky; Eugenia Raichlin; Tal Hasin; Barry A Boilson; John A Schirger; Naveen L Pereira; Brooks S Edwards; Alfredo L Clavell; Richard J Rodeheffer; Robert P Frantz; Manish J Gandhi; Simon Maltais; Soon J Park; Richard C Daly; Amir Lerman; Sudhir S Kushwaha Journal: Transplantation Date: 2013-03-27 Impact factor: 4.939
Authors: Lisa B VanWagner; Matthew E Harinstein; James R Runo; Christopher Darling; Marina Serper; Shelley Hall; Jon A Kobashigawa; Laura L Hammel Journal: Am J Transplant Date: 2017-11-18 Impact factor: 8.086