Simultaneous Heart and Kidney Transplantation: A Systematic Review and Proportional Meta-Analysis of Its Characteristics and Long-Term Variables

Transpl Int. 2024 May 31:37:12750. doi: 10.3389/ti.2024.12750. eCollection 2024.

Abstract

Patients with end-stage heart disease who undergo a heart transplant frequently have simultaneous kidney insufficiency, therefore simultaneous heart and kidney transplantation is an option and it is necessary to understand its characteristics and long-term variables. The recipient characteristics and operative and long-term variables were assessed in a meta-analysis. A total of 781 studies were screened, and 33 were thoroughly reviewed. 15 retrospective cohort studies and 376 patients were included. The recipient's mean age was 51.1 years (95% CI 48.52-53.67) and 84% (95% CI 80-87) were male. 71% (95% CI 59-83) of the recipients were dialysis dependent. The most common indication was ischemic cardiomyopathy [47% (95% CI 41-53)] and cardiorenal syndrome [22% (95% CI 9-35)]. Also, 33% (95% CI 20-46) of the patients presented with delayed graft function. During the mean follow-up period of 67.49 months (95% CI 45.64-89.33), simultaneous rejection episodes of both organ allografts were described in 5 cases only. Overall survival was 95% (95% CI 88-100) at 30 days, 81% (95% CI 76-86) at 1 year, 79% (95% CI 71-87) at 3, and 71% (95% CI 59-83) at 5 years. Simultaneous heart and kidney transplantation is an important option for concurrent cardiac and renal dysfunction and has acceptable rejection and survival rates.

Keywords: heart transplantation; kidney transplantation; multiorgan transplant; simultaneous heart and kidney transplantation; transplant.

Publication types

  • Systematic Review
  • Meta-Analysis
  • Review

MeSH terms

  • Cardio-Renal Syndrome / surgery
  • Delayed Graft Function
  • Female
  • Graft Rejection*
  • Graft Survival*
  • Heart Failure / mortality
  • Heart Failure / surgery
  • Heart Transplantation*
  • Humans
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / surgery
  • Kidney Transplantation*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome

Grants and funding

The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.