title: [The first successful combined heart-kidney transplantation in Hungary].
abstract: 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 remains to be established whether it has a jeopardizing impact on patient and graft outcome. The authors report their experience of the first successful combined heart-kidney transplantation in Hungary from a single donor and review the literature in order to clarify this issue. Young male patient candidate for heart transplantation was suffering from concurrent end stage kidney disease. Donor was selected on the basis of weight and size matching, AB0 compatibility and negative T-cell cross-match. The heart was grafted first, and after the hemodynamic stabilization kidney from the same donor was transplanted. The surgical procedure was uneventful. Heart and kidney function recovered quickly, and the patient is doing very well with good cardiac and renal function even a year following the double organ transplantation. The first Hungarian experience showed that combined heart-kidney transplantation is a therapeutic solution for patients with end stage heart and kidney failure. The lower rate of rejection compared to single heart or kidney transplantation, known from the literature as well, supports their current approach to immunosuppression.
authors.affiliation: Semmelweis Egyetem, Altalános Orvostudományi Kar Transzplantációs és Sebészeti Klinika, Budapest, Hungary. bentom@hotmail.com
authors.forename: Tamás
authors.initials: T
authors.lastname: Benko
authors.forename: Imre
authors.initials: I
authors.lastname: Fehérvári
authors.forename: Kristóf
authors.initials: K
authors.lastname: Rácz
authors.forename: Orsolya
authors.initials: O
authors.lastname: Friedrich
authors.forename: Ildikó
authors.initials: I
authors.lastname: Gálfy
authors.forename: Szilárd
authors.initials: S
authors.lastname: Török
authors.forename: Adám
authors.initials: A
authors.lastname: Remport
authors.forename: Jeno
authors.initials: J
authors.lastname: Járay
authors.forename: Elek
authors.initials: E
authors.lastname: Bodor
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Szabolcs
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D002311:Cardiomyopathy, Dilated / Q000150:complications / Q000209:etiology / Q000601:surgery*; D003404:Creatinine / Q000097:blood; D003422:Critical Care / Q000379:methods; D016027:Heart Transplantation; D017583:Hemodiafiltration; D006801:Humans; D006814:Hungary; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation; D008297:Male; D009203:Myocardial Infarction / Q000150:complications; D051437:Renal Insufficiency / Q000209:etiology / Q000601:surgery* / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome; D014508:Urea / Q000097:blood
chemical_list: D015415:Biomarkers; D007166:Immunosuppressive Agents; D014508:Urea; D003404:Creatinine