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Combined heart and kidney transplantation: report of two cases

Background: Combined Heart and Kidney Transplantation (CHKT) has become an accepted therapy for patients with coexisting heart and renal failure. Because only a few cases can be observed in the clinical practice, there is no guideline for this treatment and a lack of long-term follow-up.

Study Design: For a reasonable and safe application of CHKT in the clinical practice, we analysed the follow-up data of two patients who underwent combined heart and kidney transplantation in our hospital. Measures and outcomes: We described two male patients with end-stage cardiac and renal disease who underwent CHKD. Secondary allograft kidney transplantation was performed for one patient due to the dysfunction of the transplanted kidney and long-term follow-up was carried out.

Results: Two patients had lived 145 months and 13 months respectively after surgery. Factors such as the surgical procedure, perioperative vasoactive drug application, selection of immunosuppressants, Continuous Renal Replacement Therapy (CRRT) support at the time of severe right heart dysfunction, application of broad-spectrum antibiotics and antiviral drugs, etc. affected the outcomes after transplantation.

Conclusions: CHKT is an effective method for the end-stage heart and renal failure. Postoperative rejection monitoring is critical and secondary kidney transplantation is the best way for the renal failure after combined heart and kidney transplantation.

Author(s): Xuming Ni, Linhai Xu, Zhikun Yan, Renhua Sun