Background
Outcomes in recipients who have undergone combined heart and kidney transplantation
have mainly been addressed in small, single-center studies. We studied long-term results
of combined heart and kidney transplantation in a large multicenter cohort.
Methods
Between 1984 and 2007, 67 consecutive patients (61 men and 6 women) from 3 French
centers underwent combined heart and kidney transplantation. At transplantation, 38
(57%) were receiving dialysis. All patients received immediate triple immunosuppression
therapy (anti-calcineurin, steroids, azathioprine, or mycophenolate).
Results
Overall actuarial survival rates were 62.0%, 60.3%, 53.3%, and 46.5% at 1, 3, 5, and
10 years, respectively. These rates were similar to those observed in 2981 isolated
heart recipients at the 3 participating centers during the same period (respectively,
71.0%, 65.2%, 60.1%, and 47.2%, p = 0.6). Survival tended to improve during the last decade (1996 to 2007) and reached
71.1%, 67.5%, and 60% at 1, 3, and 5 years. Cardiac allograft rejection requiring
treatment occurred in 12 (17.9%). Coronary artery vasculopathy developed in 3 (9.3%).
Kidney allograft rejection occurred in 9 (13.4%). Kidney graft survival was 95.9%
at 1, 3, 5, and 10 years.
Conclusions
Long-term survival rates in a large cohort of combined heart and kidney recipients
are similar to those of isolated heart recipients in France. The rates of acute heart
and kidney rejection and angiographic coronary artery vasculopathy were low in this
patient population.
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Article info
Publication history
Published online: March 16, 2009
Accepted:
January 22,
2009
Received in revised form:
January 5,
2009
Received:
August 14,
2008
Identification
Copyright
© 2009 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.
