title: Combined heart and kidney transplantation: what is the appropriate surgical sequence?
abstract: Combined heart and kidney transplantation is increasing in frequency but there are no guidelines to establish the indications, contraindications and sequence for this surgical procedure. We report our single-centre experience on 30 consecutive patients who underwent combined heart and kidney transplant in comparison with heart transplant alone. Patients had similar preoperative characteristics in both groups. Combined heart and kidney transplant is associated with the same long-term survival rate, low cellular rejection and antibody-mediated rejection rates when compared with heart transplant alone. We did not observe any difference in the outcomes related to preoperative patient characteristics. We suggest the staged surgical approach as the preferred method for transplant.
authors.affiliation: Division of Cardiothoracic Surgery, Cedars Sinai Medical Center, Los Angeles, CA 90048, USA. andrea.ruzza@cshs.org
authors.forename: Andrea
authors.initials: A
authors.lastname: Ruzza
authors.forename: Lawrence S C
authors.initials: LS
authors.lastname: Czer
authors.forename: Alfredo
authors.initials: A
authors.lastname: Trento
authors.forename: Fardad
authors.initials: F
authors.lastname: Esmailian
mesh_terms: D000368:Aged; D005260:Female; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control; D006085:Graft Survival; D016027:Heart Transplantation / Q000009:adverse effects / Q000401:mortality / Q000592:standards; D006648:Histocompatibility; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation / Q000009:adverse effects / Q000401:mortality / Q000592:standards; D015141:Los Angeles; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents
keywords: Combined heart and kidney transplant; Heart transplant; Kidney transplant