Abstract
Background: Combined heart-kidney transplantation is an accepted therapeutic option for patients with end-stage heart disease associated with severely impaired renal function. We report our single-institutional experience with this combined procedure and long-term follow-up. Methods: Between April 1989 and August 2006, 9 patients underwent combined simultaneous heart-kidney transplantation at our center. Seven patients were male (mean age, 45.2 ± 10.12 years); 7 patients were on dialysis at transplantation. Whenever possible, donors were selected on the basis of ABO identity, weight (ratio ≥ 0.9), on-site or short-distance procurement, young age, low inotropic support, and normal renal function. Results: Mean ischemic time was 132.2 ± 57.0 minutes for the cardiac allograft and 6.0 ± 1.0 hours for the kidney. Surgical procedure was uneventful in all patients. One patient died in the intensive care unit 41 days after transplantation. Three patients died during follow-up, 1 of lung neoplasm after 6 years, 1 of cerebral stroke after 34 months, and 1 of infection and multiorgan failure after 148 months. The mortality rates led to an overall actuarial survival of 88.9% ± 10.4% at 1 year, 77.8% ± 13.6% at 5 years, and 64.8% ± 16.5% at 10 years. Seven patients lived beyond 5 years, 4 beyond 10 years, and the patient who has longest survival is patient no. 1, with 17 years of follow-up. One patient lost kidney function after 113 months. Conclusions: In selected patients, with coexisting end-stage cardiac and renal failure, combined heart-kidney transplantation with allograft from the same donor proved to have satisfactory short- and long-term results, with a low incidence of both cardiac and renal allograft rejection.
| Original language | English |
|---|---|
| Pages (from-to) | 522-527 |
| Number of pages | 6 |
| Journal | Annals of Thoracic Surgery |
| Volume | 84 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Aug 2007 |
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ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Surgery
Cite this
Long-Term Follow-Up of Simultaneous Heart and Kidney Transplantation With Single Donor Allografts : Report of Nine Cases. / Bruschi, Giuseppe; Busnach, Ghil; Colombo, Tiziano; Radaelli, Loredana; Pedrazzini, Giovanna; Garatti, Andrea; Sansalone, Cosimo V.; Frigerio, Maria; Vitali, Ettore.
In: Annals of Thoracic Surgery, Vol. 84, No. 2, 08.2007, p. 522-527.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Long-Term Follow-Up of Simultaneous Heart and Kidney Transplantation With Single Donor Allografts
T2 - Report of Nine Cases
AU - Bruschi, Giuseppe
AU - Busnach, Ghil
AU - Colombo, Tiziano
AU - Radaelli, Loredana
AU - Pedrazzini, Giovanna
AU - Garatti, Andrea
AU - Sansalone, Cosimo V.
AU - Frigerio, Maria
AU - Vitali, Ettore
PY - 2007/8
Y1 - 2007/8
N2 - Background: Combined heart-kidney transplantation is an accepted therapeutic option for patients with end-stage heart disease associated with severely impaired renal function. We report our single-institutional experience with this combined procedure and long-term follow-up. Methods: Between April 1989 and August 2006, 9 patients underwent combined simultaneous heart-kidney transplantation at our center. Seven patients were male (mean age, 45.2 ± 10.12 years); 7 patients were on dialysis at transplantation. Whenever possible, donors were selected on the basis of ABO identity, weight (ratio ≥ 0.9), on-site or short-distance procurement, young age, low inotropic support, and normal renal function. Results: Mean ischemic time was 132.2 ± 57.0 minutes for the cardiac allograft and 6.0 ± 1.0 hours for the kidney. Surgical procedure was uneventful in all patients. One patient died in the intensive care unit 41 days after transplantation. Three patients died during follow-up, 1 of lung neoplasm after 6 years, 1 of cerebral stroke after 34 months, and 1 of infection and multiorgan failure after 148 months. The mortality rates led to an overall actuarial survival of 88.9% ± 10.4% at 1 year, 77.8% ± 13.6% at 5 years, and 64.8% ± 16.5% at 10 years. Seven patients lived beyond 5 years, 4 beyond 10 years, and the patient who has longest survival is patient no. 1, with 17 years of follow-up. One patient lost kidney function after 113 months. Conclusions: In selected patients, with coexisting end-stage cardiac and renal failure, combined heart-kidney transplantation with allograft from the same donor proved to have satisfactory short- and long-term results, with a low incidence of both cardiac and renal allograft rejection.
AB - Background: Combined heart-kidney transplantation is an accepted therapeutic option for patients with end-stage heart disease associated with severely impaired renal function. We report our single-institutional experience with this combined procedure and long-term follow-up. Methods: Between April 1989 and August 2006, 9 patients underwent combined simultaneous heart-kidney transplantation at our center. Seven patients were male (mean age, 45.2 ± 10.12 years); 7 patients were on dialysis at transplantation. Whenever possible, donors were selected on the basis of ABO identity, weight (ratio ≥ 0.9), on-site or short-distance procurement, young age, low inotropic support, and normal renal function. Results: Mean ischemic time was 132.2 ± 57.0 minutes for the cardiac allograft and 6.0 ± 1.0 hours for the kidney. Surgical procedure was uneventful in all patients. One patient died in the intensive care unit 41 days after transplantation. Three patients died during follow-up, 1 of lung neoplasm after 6 years, 1 of cerebral stroke after 34 months, and 1 of infection and multiorgan failure after 148 months. The mortality rates led to an overall actuarial survival of 88.9% ± 10.4% at 1 year, 77.8% ± 13.6% at 5 years, and 64.8% ± 16.5% at 10 years. Seven patients lived beyond 5 years, 4 beyond 10 years, and the patient who has longest survival is patient no. 1, with 17 years of follow-up. One patient lost kidney function after 113 months. Conclusions: In selected patients, with coexisting end-stage cardiac and renal failure, combined heart-kidney transplantation with allograft from the same donor proved to have satisfactory short- and long-term results, with a low incidence of both cardiac and renal allograft rejection.
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U2 - 10.1016/j.athoracsur.2007.04.018
DO - 10.1016/j.athoracsur.2007.04.018
M3 - Article
VL - 84
SP - 522
EP - 527
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
SN - 0003-4975
IS - 2
ER -