Outcomes of simultaneous heart–kidney and lung–kidney transplantations: the Australian and New Zealand experience

Abstract

The Australian and New Zealand experience of SHK and SLK includes 38 patients with a high 1-year mortality, but excellent 5- and 10-year survivals. Based on this, it seems reasonable to continue to offer combined organ transplantation to select patients with dual organ failure.

Selection Criteria for Lung Transplantation: Controversies and New Developments

“…91 It is common for SLuK patients to be listed before receiving chronic dialysis, due to the concern that post-lung transplantation complications and calcineurin use could cause the patients chronic kidney disease to proceed to end-stage kidney disease. 98,99 It is known that patients with preexisting renal impairment undergoing lung transplantation have higher mortality and morbidity compared with patients with normal renal function, and in this patient group, it could be sensible to perform SLuK instead of consecutive transplantations. 99 Another possible abdominal transplantation type is pancreas transplantation.…”

“…98,99 It is known that patients with preexisting renal impairment undergoing lung transplantation have higher mortality and morbidity compared with patients with normal renal function, and in this patient group, it could be sensible to perform SLuK instead of consecutive transplantations. 99 Another possible abdominal transplantation type is pancreas transplantation. There are less data available, but CF patients with exocrine and endocrine pancreas dysfunction eligible for lung transplantation could well benefit from this procedure.…”

Cardiac Outcomes in Isolated Heart and Simultaneous Kidney and Heart Transplants in the United States

“…4 Both single-center as well as previous analyses of the United Network for Organ Sharing (UNOS) database have shown similar patient survival between heart transplant alone (HTA) and simultaneous kidney-heart transplant (SKHT) recipients. [2][3][4][5][6] On the other hand, simultaneous kidney transplant appears to provide immunoprotection to the cardiac allograft and hence improved cardiac graft outcomes in SKHT recipients when compared to HTA recipients. 3,4,7 According to the Organ Procurement and Transplantation Network (OPTN)/UNOS data, the number of heart transplants performed every year in the United States increased by 61%, from 2,199 in 2000 to 3,552 in 2019.…”

Dilemmas for the Cardiac Anesthesiologist: Managing Conflicting Fluid Management Strategies During Combined Heart-Kidney Transplantation

“…IT IS WELL-DESCRIBED that patients undergoing heart transplantation with coexisting renal dysfunction have higher morbidity and mortality than those without renal impairment. 1 A glomerular filtration rate (GFR) of 30 mL/min is considered to be a relative contraindication for heart transplantation alone. 2 In the past, patients with concurrent heart and kidney failure were not considered as candidates for heart transplantation.…”

“…3 Similarly, significant heart or lung disease excluded patients with renal disease from kidney transplantation alone. 1 Several studies have shown that in selected patients, combined heart-kidney transplantation (HKT) or lung-kidney transplantation is safe to perform and demonstrates similar survival outcomes as for those who undergo a heart or lung transplantation alone. 1,[3][4][5][6][7][8] According to the United Network for Organ Sharing national database, 1,445 HKTs had been performed in the United States through September 30, 2017.…”