The mean age was 46.4 years, mean donor age was 30.1 years, 30% of recipients were females, 64.6% were White, 19.6% were Black, 11.9% were Hispanic, 14.7% were diabetic, 7.1% were on dialysis, 61.5% were on life support & 20% were listed as status 1A at the time of transplantation. These findings were similar between the induction & the non-induction groups. Of the 260 patients, 134 (52%) patients received induction therapy. Of these, 36% received IL-2 receptor antagonists, 28% received Thymoglobulin, 23% received ATGAM, 6% received Campath & 6% received OKT3. Survival in combined heart-liver transplant recipients was comparable to that of recipients of heart transplant only (P=0.63). Across 15 years of follow up, survival was similar among patients who received induction therapy versus no induction therapy (P=0.62). Subgroup analysis showed no survival difference among the studied induction agents across 15 years of follow up (P=0.80). Approximately 6.7% of the non-induction group patients had at least 1 episode of acute rejection versus 2.4% of the induction group patients (P=0.13), which indicates a favorable trend in the induction group.
Conclusion:In this retrospective analysis of the UNOS database, recipients of combined heart-liver transplantation have comparable survival to recipients of heart transplantation only. Induction immunosuppressive therapy was not associated with improved survival in patients undergoing combined heart-liver transplantation however showed a favorable trend towards less acute rejection.
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