Combined heart-kidney transplantation: the University of Wisconsin experience.
BACKGROUND
Combined heart-kidney transplantation (HKTx) is increasing in frequency, but long-term outcomes are unknown and appropriately comparative analysis is lacking.


METHODS
This study was a retrospective review of prospectively collected data for 19 HKTx patients. Patient and graft survival, graft rejection and coronary allograft vasculopathy (CAV) were compared for HKTx vs recipients of a heart (n = 515) or kidney alone (n = 3,188) or both organs at separate time-points (n = 8).


RESULTS
Patient and graft survival did not differ for HKTx vs any group. HKTx time to first rejection episode was significantly prolonged for both organs vs single-organ recipients. The incidence of CAV was significantly lower for HKTx.


CONCLUSIONS
HKTx provides outcomes similar to those for solitary heart or kidney transplantation. There may be an immunologic advantage to receiving organs in a combined fashion. Such allocation of organs seems medically appropriate; however, more refined strategies are needed to identify optimal recipient populations.
Hermsen
Joshua L
JL
Division of Cardiothoracic Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53791-7375, USA. hermsen@surgery.wisc.edu
Nath
Dilip S
DS
del Rio
Alejandro Munoz
AM
Eickstaedt
Joshua B
JB
Wigfield
Christopher
C
Lindsey
Joshua D
JD
Edwards
Niloo M
NM
D000046:Academic Medical Centers / Q000706:statistics & numerical data*; D000328:Adult; D003324:Coronary Artery Disease / Q000209:etiology; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D016027:Heart Transplantation / Q000009:adverse effects / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation / Q000009:adverse effects / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014922:Wisconsin