"Long-term results of combined heart and kidney transplantation: a French multicenter study"

Long-term results of combined heart and kidney transplantation: a French multicenter study. The Journal of heart and lung transplantation: the official publication of the International Society for Heart Transplantation 2009;28(5):440-5. 2009: Vermes Emmanuelle; Grimbert Philippe; Sebbag Laurent; Barrou Benoit; Pouteil-Noble Claire; Pavie Alain; Obadia Jean François; Loisance Daniel; Lang Philippe; Kirsch Matthias

"BACKGROUND: Outcomes in recipients who have undergone combined heart and kidney transplantation have mainly been addressed in small, single-center studies. We studied long-term results of combined heart and kidney transplantation in a large multicenter cohort. METHODS: Between 1984 and 2007, 67 consecutive patients (61 men and 6 women) from 3 French centers underwent combined heart and kidney transplantation. At transplantation, 38 (57 per cent) were receiving dialysis. All patients received immediate triple immunosuppression therapy (anti-calcineurin, steroids, azathioprine, or mycophenolate). RESULTS: Overall actuarial survival rates were 62.0 per cent, 60.3 per cent, 53.3 per cent, and 46.5 per cent at 1, 3, 5, and 10 years, respectively. These rates were similar to those observed in 2981 isolated heart recipients at the 3 participating centers during the same period (respectively, 71.0 per cent, 65.2 per cent, 60.1 per cent, and 47.2 per cent, p = 0.6). Survival tended to improve during the last decade (1996 to 2007) and reached 71.1 per cent, 67.5 per cent, and 60 per cent at 1, 3, and 5 years. Cardiac allograft rejection requiring treatment occurred in 12 (17.9 per cent). Coronary artery vasculopathy developed in 3 (9.3 per cent). Kidney allograft rejection occurred in 9 (13.4 per cent). Kidney graft survival was 95.9 per cent at 1, 3, 5, and 10 years. CONCLUSIONS: Long-term survival rates in a large cohort of combined heart and kidney recipients are similar to those of isolated heart recipients in France. The rates of acute heart and kidney rejection and angiographic coronary artery vasculopathy were low in this patient population."

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