Renal graft outcome in combined heart-kidney transplantation compared to kidney transplantation alone: a single-center, matched-control study

Thorac Cardiovasc Surg. 2012 Feb;60(1):57-63. doi: 10.1055/s-0031-1299574. Epub 2012 Jan 10.

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.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Biomarkers / blood
  • Case-Control Studies
  • Creatinine / blood
  • Germany
  • Graft Rejection / etiology
  • Graft Rejection / prevention & control
  • Graft Survival* / drug effects
  • Heart Diseases / complications
  • Heart Diseases / mortality
  • Heart Diseases / surgery*
  • Heart Transplantation* / adverse effects
  • Heart Transplantation* / mortality
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Kaplan-Meier Estimate
  • Kidney Transplantation* / adverse effects
  • Kidney Transplantation* / mortality
  • Male
  • Middle Aged
  • Renal Insufficiency / complications
  • Renal Insufficiency / mortality
  • Renal Insufficiency / surgery*
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Young Adult

Substances

  • Biomarkers
  • Immunosuppressive Agents
  • Creatinine