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ISSN 2448-5640 (Print)
Diario Oficial de la Sociedad Mexicana de Cirugía Cardiaca, A.C., y del Colegio Mexicano de Cirugía Cardiovascular y Torácica, A.C.

2023, Number 1

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Cir Card Mex 2023; 8 (1)

Combined Transplantation: Survival and Complications in Heart-Lung and Heart-Kidney Transplant. A single institution experience

Orozco-Hernández EJ, Góngora E, Kaleekal T, Wille K, Rusanov V, Tallaj J, Mcelwee SK, Anderson DJ, Locke JE, Kirklin JK, Hoopes CW

Language: English
References: 41
Page: 5-11
PDF size: 425.76 Kb.


ABSTRACT

Objective. Multi-organ transplants (MOT) have been increasing. The most common are Heart-Kidney (HKT) and Heart-Lung (HLT). We present our experience, morbidity and mortality on HKTand HLT. Material. This is a retrospective review of all HKT and HLT between January 2015 and May 2022. Patient transplants were performed at a single large referral center. Patient demographics, morbidity and mortality were collected. Results. Seventeen HLT and 8 HKT were performed. On the HLT, mean age was 37 ± 15.6 years. The most common indication for ECMO support was acute cor pulmonale (73%,). The most common complications on ECMO support were bacteremia 82%. Post-transplant complications included vocal cord paralysis on 36% .The mortality in the ECMO B-HLT group was 9% at thirty- days and 18% at one year mortality . Follow-up was at 7 years. Long term mortality was 15 %, 30 % with at least one acute episode of rejection, 15% had evidence of Bronchiolitis Obliterans Syndrome (BOS). On the HKT, the mean age was 51.2 ± 10.7. The most common diagnosis was Idiopathic Cardiomyopathy (50%) and hypertensive nephropathy. All HKT was performed in 2 stages, Mortality was 12% (n=1) during the first year, and 12% later. Complications were 12% with severe primary graft dysfunction of the heart, 25% developed coronary artery vasculopathy (CAV). The most common complication was infection (62 %). Conclusions. Outcomes of HKT and HLT are highly favorable, preferred treatment option for select patients. In appropriately selected patients, can be undertaken with acceptable morbidity and conditional survival.


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