title: Combined heart-kidney transplantation after total artificial heart insertion.
abstract: We present the first single-center report of 2 consecutive cases of combined heart and kidney transplantation after insertion of a total artificial heart (TAH). Both patients had advanced heart failure and developed dialysis-dependent renal failure after implantation of the TAH. The 2 patients underwent successful heart and kidney transplantation, with restoration of normal heart and kidney function. On the basis of this limited experience, we consider TAH a safe and feasible option for bridging carefully selected patients with heart and kidney failure to combined heart and kidney transplantation. Recent FDA approval of the Freedom driver may allow outpatient management at substantial cost savings. The TAH, by virtue of its capability of providing pulsatile flow at 6 to 10 L/min, may be the mechanical circulatory support device most likely to recover patients with marginal renal function and advanced heart failure.
authors.affiliation: Cedars-Sinai Heart Institute, Division of Cardiothoracic Surgery, Cedars Sinai Medical Center, Los Angeles, California, United States.
authors.forename: A
authors.initials: A
authors.lastname: Ruzza
authors.affiliation: Cedars-Sinai Heart Institute, Division of Cardiology, Cedars Sinai Medical Center, Los Angeles, California, United States. Electronic address: lawrence.czer@cshs.org.
authors.forename: L S C
authors.initials: LS
authors.lastname: Czer
authors.affiliation: Cedars-Sinai Heart Institute, Division of Cardiothoracic Surgery, Cedars Sinai Medical Center, Los Angeles, California, United States.
authors.forename: K A
authors.initials: KA
authors.lastname: Ihnken
authors.affiliation: Cedars-Sinai Heart Institute, Division of Cardiothoracic Surgery, Cedars Sinai Medical Center, Los Angeles, California, United States.
authors.forename: M
authors.initials: M
authors.lastname: Sasevich
authors.affiliation: Cedars-Sinai Heart Institute, Division of Cardiothoracic Surgery, Cedars Sinai Medical Center, Los Angeles, California, United States.
authors.forename: A
authors.initials: A
authors.lastname: Trento
authors.affiliation: Cedars-Sinai Heart Institute, Division of Cardiothoracic Surgery, Cedars Sinai Medical Center, Los Angeles, California, United States.
authors.forename: D
authors.initials: D
authors.lastname: Ramzy
authors.affiliation: Cedars-Sinai Heart Institute, Division of Cardiothoracic Surgery, Cedars Sinai Medical Center, Los Angeles, California, United States.
authors.forename: F
authors.initials: F
authors.lastname: Esmailian
authors.affiliation: Cedars-Sinai Heart Institute, Division of Cardiology, Cedars Sinai Medical Center, Los Angeles, California, United States.
authors.forename: J
authors.initials: J
authors.lastname: Moriguchi
authors.affiliation: Cedars-Sinai Heart Institute, Division of Cardiology, Cedars Sinai Medical Center, Los Angeles, California, United States.
authors.forename: J
authors.initials: J
authors.lastname: Kobashigawa
authors.affiliation: Cedars-Sinai Heart Institute, Division of Cardiothoracic Surgery, Cedars Sinai Medical Center, Los Angeles, California, United States.
authors.forename: F
authors.initials: F
authors.lastname: Arabia
mesh_terms: D005260:Female; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D016027:Heart Transplantation; D006354:Heart, Artificial; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011673:Pulsatile Flow