Combined heart and kidney transplantation using a single donor - A single center's experience with nine cases

Background. Simultaneous double-organ transplants comprising various organ combinations have become frequent. The purpose of this article is to report on a single center's experience of simultaneous heart and kidney transplan tation (HNTX) with particular emphasis on selection criteria and patient ou tcome. Methods. From September 1990 to January 1997, nine patients underwent HNTX, receiving both grafts from a single donor selected on ABO blood group comp atibility and a negative lymphocytotoxic crossmatch, but without regard to HLA-antigen matching. Results. One patient died of acute humoral rejection of the cardiac graft s hortly after surgery. Eight patients are alive and well and have normal car diac and renal function at a mean follow-up of 44+/-28 months. Conclusion. HNTX offers a compelling therapeutic solution in the treatment of advanced cardiac and renal failure in carefully selected patients. Becau se the heart and kidney rejection episodes were independent of each other, rejection surveillance should be carried out separately for each transplant ed organ.