The Journal of Heart and Lung Transplantation
Volume 27, Issue 7 , Pages 753-759, July 2008

Current State of Combined Heart–Liver Transplantation in the United States

  • Helen S. Te, MD

      Affiliations

    • Center for Liver Diseases, Department of Medicine, University of Chicago Medical Center, Chicago, Illinois
    • Corresponding Author InformationReprint requests: Helen S. Te, MD, Center for Liver Diseases, University of Chicago Medical Center, 5841 South Maryland Avenue, MC 7120, Chicago, IL 60637. Telephone: 773-702-2395. Fax: 773-834-1288.
    • ,
  • Allen S. Anderson, MD

      Affiliations

    • Section of Cardiology, Department of Medicine, University of Chicago Medical Center, Chicago, Illinois
    • ,
  • J. Michael Millis, MD

      Affiliations

    • Section of Transplant Surgery, Department of Surgery, University of Chicago Medical Center, Chicago, Illinois
    • ,
  • Valluvan Jeevanandam, MD

      Affiliations

    • Section of Cardiac and Thoracic Surgery, Department of Surgery, University of Chicago Medical Center, Chicago, Illinois.
    • ,
  • Donald M. Jensen, MD

      Affiliations

    • Center for Liver Diseases, Department of Medicine, University of Chicago Medical Center, Chicago, Illinois

Received 18 February 2008; received in revised form 18 February 2008; accepted 21 April 2008.

Background

Combined heart–liver transplantation (CHLT) has been increasingly performed in the USA, but published data on overall patient and graft outcomes have been limited.

Methods

This study aimed to review the indications, immunosuppression, complications and outcomes of CHLT in the USA. From October 1987 to December 2005, a total of 47 cases of combined heart–liver (n = 41) and heart–liver–kidney transplantation (n = 6) were reported to the United Network for Sharing (UNOS) database. One pediatric case was excluded from the analysis. The mean age of recipients was 46 years (range, 22 to 65 years) and included 31 (67%) men and 16 (33%) women.

Results

The most common indication for both heart and liver transplantation was amyloidosis (30%). Patients were followed for a mean duration of 1,362 days or 3.7 years (range, 1 to 4,598 days or 0 to 12.6 years). Patient, heart and liver graft survival rates were 84.8%, 84.8% and 82.4% at 1 year, and 75.6%, 75.6% and 73.5% at 5 years, respectively. At the latest follow-up of patients who survived at least 6 months after transplantation (n = 39), 28.2% of patients were on a single immunosuppressive agent.

Conclusions

Combined heart–liver transplantation is a viable option for candidates who require the combined transplantation, with outcomes comparable to those of single-organ recipients.

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 Supported in part by Health Resources and Services Administration Contract No. 234-2005-370011C. The content is the responsibility of the authors and does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products or organizations imply endorsement by the U.S. Government.

PII: S1053-2498(08)00349-5

doi:10.1016/j.healun.2008.04.004

The Journal of Heart and Lung Transplantation
Volume 27, Issue 7 , Pages 753-759, July 2008

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