Combined heart-kidney transplantation: report on six cases

被引:16
作者
Col, VJ
Jacquet, L
Squifflet, JP
Goenen, M
Noirhomme, P
Goffin, E
Pirson, Y
机构
[1] Univ Louvain, Sch Med, Clin Univ St Luc, Dept Nephrol,Nephrol Unit, B-1200 Brussels, Belgium
[2] Univ Louvain, Sch Med, Clin Univ St Luc, Dept Kidney & Pancreas Transplantat, B-1200 Brussels, Belgium
[3] Univ Louvain, Sch Med, Clin Univ St Luc, Dept Heart Transplantat, B-1200 Brussels, Belgium
[4] Univ Louvain, Sch Med, Clin Univ St Luc, Dept Intens Care, B-1200 Brussels, Belgium
关键词
combined transplantation; heart failure; heart rejection; heart transplantation; kidney rejection; kidney transplantation; renal failure; transplantation outcome;
D O I
10.1093/ndt/13.3.723
中图分类号
R3 [基础医学]; R4 [临床医学];
学科分类号
1001 ; 1002 ; 100602 ;
摘要
Background, Combined heart-kidney transplantation has become a new therapeutic solution for patients with coexisting, irreversible heart and kidney failure. Though this combined approach has several theoretical advantages over sequential transplantation, it has yet to be established that it does not jeopardize patient and graft outcomes. We here report our experience with six cases of combined heart-kidney transplantation from single donors and review the literature in order to clarify this issue. Methods. Four patients were kidney-transplant candidates with severe heart failure and two were heart-transplant candidates with independent chronic renal failure. Donors were selected on the basis of weight and size matching, ABO compatibility, and negative T-cell cross-match. Results. The heart was always grafted first. The surgical procedure was uneventful in all cases. Heart and kidney function recovered quickly in all patients. Two patients died, one at day 45 from heart subacute rejection and the other one at day 157 from cerebral haemorrhage. The four remaining patients are alive 23-84 months after transplantation (2-year survival rate: 67%) and have well-functioning kidneys (creatinine clearance 31-83 ml/min) and hearts (left ventricular ejection fraction 53-83%). Remarkably, four of six patients had no acute rejection episode of either organ. These patient and graft outcomes are in agreement with previous reports and compare favourably with the results of isolated heart and kidney transplantation. Conclusions. Combined heart-kidney transplantation from the same donor should be proposed to patients who would qualify for transplantation of each organ within a few years.
引用
收藏
页码:723 / 727
页数:5
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