Indications, evaluations, and postoperative care of the combined liver-heart transplant recipient.
Multiorgan transplantation is now possible because of improvements in immunosuppression and surgical techniques. Combined liver-heart transplantation (CLHT) is a new option with initial 1-year data reporting 80% 1-year survival rates. Organs transplanted with the liver appear to have less allograft rejection. Within the United States, fifteen CLHTs have been performed. Three CLHTs have been performed at the University of Chicago and are discussed in this article. Guidelines for evaluation and listing criteria for CLHT recipients have not been established in the medical community. Postoperative care of this patient group is demanding and requires a thorough understanding of multiorgan pathophysiology, management of high-incidence acute renal dysfunction, tight intravascular volume regulation, and an experienced multidisciplinary approach to care.
Tazbir
J S
JS
Purdue University Calumet, Hammond, IN 46323, USA.
Cronin
D C
DC
D006084:Graft Rejection / Q000517:prevention & control; D006331:Heart Diseases / Q000150:complications / Q000601:surgery; D016027:Heart Transplantation / Q000009:adverse effects / Q000276:immunology / Q000379:methods* / Q000451:nursing*; D006801:Humans; D008107:Liver Diseases / Q000150:complications / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects / Q000276:immunology / Q000379:methods* / Q000451:nursing*; D010348:Patient Care Team; D018579:Patient Selection; D011182:Postoperative Care / Q000379:methods* / Q000451:nursing*; D017410:Practice Guidelines as Topic; D011300:Preoperative Care / Q000379:methods* / Q000451:nursing*; D009927:Tissue and Organ Procurement / Q000379:methods; D014481:United States; D014850:Waiting Lists