title: Renal graft outcome in combined heart-kidney transplantation compared to kidney transplantation alone: a single-center, matched-control study.
abstract: BACKGROUND
  Renal allograft outcome in heart-kidney transplantation (HKTx) might be affected by hemodynamic instability and high levels of calcineurin inhibitor-dependent immunosuppression.
  
  
  METHODS
  From November 1999 to March 2008, 13 patients who received HKTx were compared with a matched control group of 13 kidney transplantation (KTx) recipients with similar cardiovascular risk factors. Graft function, rejection periods, and patient survival were analyzed.
  
  
  RESULTS
  Renal allograft rejection was noted in three patients (23%) after HKTx and in four patients (31%) after KTx. Serum creatinine levels were comparable at 1 week, 1 month, 1, 2, and 3 years after transplantation. Patient survival rates at 1, 2, and 3 years were 100% for HKTx recipients and 100, 92, and 92% for isolated KTx patients. Graft survival was 92% at 1, 2, and 3 years after HKTx and 100% at 1 year and 92% at 2 and 3 years after isolated KTx.
  
  
  CONCLUSIONS
  Our results with excellent long-term graft function and survival after combined HKTx indicate that this procedure is a valuable option for a growing number of patients suffering from coexistent cardiac and renal failure.
authors.affiliation: Department of General and Visceral Surgery, University of Muenster, Muenster, Germany.
authors.forename: L
authors.initials: L
authors.lastname: Kebschull
authors.forename: C
authors.initials: C
authors.lastname: Schleicher
authors.forename: D
authors.initials: D
authors.lastname: Palmes
authors.forename: J
authors.initials: J
authors.lastname: Sindermann
authors.forename: B
authors.initials: B
authors.lastname: Suwelack
authors.forename: N
authors.initials: N
authors.lastname: Senninger
authors.forename: H
authors.initials: H
authors.lastname: Wolters
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D003404:Creatinine / Q000097:blood; D005858:Germany; D006084:Graft Rejection / Q000209:etiology / Q000517:prevention & control; D006085:Graft Survival / Q000187:drug effects; D006331:Heart Diseases / Q000150:complications / Q000401:mortality / Q000601:surgery*; D016027:Heart Transplantation / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation / Q000009:adverse effects / Q000401:mortality; D008297:Male; D008875:Middle Aged; D051437:Renal Insufficiency / Q000150:complications / Q000401:mortality / Q000601:surgery*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015415:Biomarkers; D007166:Immunosuppressive Agents; D003404:Creatinine