Simultaneous heart and kidney transplantation in patients with end-stage heart and renal failure

被引:24
|
作者
Leeser, DB
Jeevanandam, V
Furukawa, S
Eisen, H
Mather, P
Silva, P
Guy, S
Foster, CE
机构
[1] Temple Univ Hosp & Med Sch, Dept Surg, Philadelphia, PA 19140 USA
[2] Univ Chicago, Dept Surg, Chicago, IL 60637 USA
[3] Temple Univ, Sch Med, Dept Med, Philadelphia, PA 19122 USA
[4] Temple Univ, Sch Med, Dept Surg, Philadelphia, PA 19122 USA
关键词
combined heart kidney transplantation; end-stage renal disease; heart failure; heart transplantation; renal transplantation;
D O I
10.1034/j.1600-6143.2001.010116.x
中图分类号
R61 [外科手术学];
学科分类号
摘要
Combined simultaneous organ transplantation has become more common as selection criteria for transplantation have broadened. Broadening selection criteria is secondary to improved immunosuppression and surgical techniques. The kidney is the most common extra-thoracic organ to be simultaneously transplanted with the heart. A series of 13 patients suffering from both end-stage heart and renal failure underwent 14 simultaneous heart and kidney transplantations at Temple University Hospital between 1990 and 1999. This is the largest series reported from a single center. Three patients died during the initial hospitalization for an in-hospital mortality of 21%. Of 10 patients who left the hospital, 1-year survival was 100% and 2-year survival 75%. One patient required retransplant for rejection within the first year. Overall mortality at 1 and 2 years was 25 and 41%, respectively. Four out of nine (44%) patients greater than 5 years post-transplant were alive. Of the 10 patients who left the hospital, 66% were alive at 5 years. One patient succumbed to primary nonfunction of the cardiac allograft, while the four other deaths were secondary to bacterial or fungal sepsis. The patient's racial backgrounds were equally divided between African-American and white. These results are similar to those reported in a United Network of Organ Sharing Database (UNOS) registry analysis of 84 simultaneous heart and kidney transplants that found 1- and 2-year survival to be 76 and 67%, respectively. Simultaneous heart and kidney transplantation continues to be a viable option for patients suffering from failure of these two organ systems, although the results do not match those of heart transplant alone.
引用
收藏
页码:89 / 92
页数:4
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