title: Implantation of the liver during reperfusion of the heart in combined heart-liver transplantation: own experience and review of the literature.
abstract: BACKGROUND
  There are only a few reports about combined heart-liver transplantations. The surgical techniques differ widely, ranging from sequential implantation of the organs to simultaneous transplantations. We report our experience with simultaneous, combined heart-liver transplantations without using a veno-venous bypass demonstrating that this is a feasible surgical technique.
  
  
  METHODS
  Since 2005, we performed 4 combined heart-liver transplantations by implanting the liver during the reperfusion period of the newly implanted heart. We retrospectively reviewed patient clinical data and outcomes.
  
  
  RESULTS
  The mean operative time was 534 ± 247 minutes and the ischemia times for heart and liver were 190 ± 72 minutes (cold ischemia time for the heart), 98 ± 96 minutes (warm ischemia time for the heart), 349 ± 101 minutes (cold ischemia time for the liver), and 36.25 ± 3.5 minutes (warm ischemia time for the liver). Three patients were discharged from the hospital after an uneventful clinical course. One patient died due to multi-organ failure during the intensive care unit stay on the 23rd postoperative day.
  
  
  CONCLUSIONS
  We suggest that combined, simultaneous heart-liver transplantation without veno-venous bypass is a feasible surgical technique.
authors.affiliation: Department of General, Visceral and Vascular Surgery, Friedrich-Schiller-University Jena, Jena, Germany. Falk.Rauchfuss@med.uni-jena.de
authors.forename: F
authors.initials: F
authors.lastname: Rauchfuss
authors.forename: M
authors.initials: M
authors.lastname: Breuer
authors.forename: Y
authors.initials: Y
authors.lastname: Dittmar
authors.forename: M
authors.initials: M
authors.lastname: Heise
authors.forename: T
authors.initials: T
authors.lastname: Bossert
authors.forename: K
authors.initials: K
authors.lastname: Hekmat
authors.forename: U
authors.initials: U
authors.lastname: Settmacher
mesh_terms: D006085:Graft Survival; D016027:Heart Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016031:Liver Transplantation; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D007166:Immunosuppressive Agents