Combined cardiorenal transplant in heart and advanced renal disease

  • Margarita Peradejordi Lastras División Trasplante Intratorácico e Insuficiencia Cardíaca, Hospital Universitario Fundación Favaloro, Buenos Aires
  • Liliana Ethel Favaloro División Trasplante Intratorácico e Insuficiencia Cardíaca, Hospital Universitario Fundación Favaloro, Buenos Aires
  • Rita Marcela Fortunato Unidad Renal, Hospital Universitario Fundación Favaloro, Buenos Aires
  • Luis Gutiérrez Unidad Renal, Hospital Universitario Fundación Favaloro, Buenos Aires
  • Gabriel Eduardo Rabin Unidad Renal, Hospital Universitario Fundación Favaloro, Buenos Aires
  • Daniel Oscar Absi División Trasplante Intratorácico e Insuficiencia Cardíaca, Hospital Universitario Fundación Favaloro, Buenos Aires
  • José Abud División Trasplante Intratorácico e Insuficiencia Cardíaca, Hospital Universitario Fundación Favaloro, Buenos Aires
  • Héctor Raffaelli Unidad Renal, Hospital Universitario Fundación Favaloro, Buenos Aires
  • Rodolfo Marrugat Unidad Renal, Hospital Universitario Fundación Favaloro, Buenos Aires
  • Hugo Fraguas Unidad Renal, Hospital Universitario Fundación Favaloro, Buenos Aires
  • Roberto René Favaloro División Trasplante Intratorácico e Insuficiencia Cardíaca, Hospital Universitario Fundación Favaloro, Buenos Aires
  • Pablo Raffaele Unidad Renal, Hospital Universitario Fundación Favaloro, Buenos Aires
  • Alejandro Mario Bertolotti División Trasplante Intratorácico e Insuficiencia Cardíaca, Hospital Universitario Fundación Favaloro, Buenos Aires
Keywords: cardiac transplant, renal transplant, cardiorenal transplant, combined transplant, renal failure

Abstract

Introduction: Renal failure (RF) is a post cardiac transplantation predictor of morbimortality. The combined cardiorenal transplant (CCRTx) in cardiac transplantation (CTx) candidates with chronic renal disease is a therapeutic option. Our aim was to evaluate the CCRTx follow up outcomes in a single Centre. Methods: Between 2/1993 and 12/2014 we performed 442 CTx. Since 2006, 20 patients (p) underwent CCRTx using allografts from the same donor. The inclusion criteria were: RF with CrCl ≤ 40 mil/min or dialysis requirement in CTx candidates. All p received Thymoglobulin and immunosuppression with tacrolimus, mycophenolate mofetil and steroids.Median follow up: 46 months (7-96). Results: Mean age: 58±7 years, 85% were male. Mean Creatinine (Cr): 3,1±2,5 mg/dl and ClCr 27,5+10 mil/min. Three p required dialysis during the pre-transplantation phase and 4 p were under chronic dialysis. Etiologies: cardiomyopathies: coronary 10 p, noncoronary 9 p and re CTx, 1 p; nephropathies: nephroangiosclerosis 5 p, cardiorenal syndrome 10 p, diabetes 2 p, glomerulopathy 1 p, polycystosis 1 p and toxic nephritis 1 p. At 30 days and 1 year post CCRTx, Cr was 1,2±0,4 mg/dl and 1,1±0,2 mg/dl respectively. In-hospital mortality was 3/20 p (15%), 2 p due to sepsis and 1 p due to cardiac graft failure. Late mortality 5/17 p (29 %), 4p due to sepsis and 1 p due to liver sarcoma. Survival at 1 and 3 years was 76 and 72%, respectively. Conclusions: In our series CCRTx was a safe and effective treatment for CTx candidates with CrCl < 40 ml/min.

Author Biography

Luis Gutiérrez, Unidad Renal, Hospital Universitario Fundación Favaloro, Buenos Aires
Los autores declaran no poseer ningún interés comercial o asociativo que presente un conflicto de intereses con el
trabajo presentado.

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Published
2017-04-24
How to Cite
1.
Peradejordi Lastras M, Favaloro LE, Fortunato RM, Gutiérrez L, Rabin GE, Absi DO, Abud J, Raffaelli H, Marrugat R, Fraguas H, Favaloro RR, Raffaele P, Bertolotti AM. Combined cardiorenal transplant in heart and advanced renal disease. Rev Nefrol Dial Traspl. [Internet]. 2017Apr.24 [cited 2024Jul.16];35(4):188-95. Available from: http://revistarenal.org.ar/index.php/rndt/article/view/40
Issue
Vol. 35 No. 4 (2015): Oct.-Dic.
Section
Original Article