Life-Saving Combined Heart-Kidney Transplantation in a Previous Sequential Heart and Kidney Transplant Recipient.

PURPOSE: Solid organ re-transplantation in the context of allograft failure is a challenging clinical and ethical problem. Ideally, solid organ re-transplantation after initial allograft failure should be performed in all recipients, but this is often not clinically or logistically feasible.

METHODS

This report details what we believe is the first combined heart-kidney transplant in a recipient of a previous sequential heart and kidney transplant.

RESULTS

Eight years after a combined heart and kidney transplant after initially receiving a sequential heart and kidney transplant, a 31-year-old man is doing extremely well, with no rejection episodes or significant complications after transplantation.

SUMMARY: This case confirms that combined heart and kidney transplantation is a viable option for tackling the complex issue of graft failure in recipients of previous cardiac and renal grafts.

LEARNING POINTS: Good short- and long-term outcomes following combined heart-kidney transplantation can be achieved in patients with multi-system end-organ dysfunction.Advances in immunosuppressant therapy have enabled multiple transplantation procedures from different donors in a single recipient.We describe the first recipient in the world of combined heart-kidney transplantation on a background of previous sequential heart-kidney transplantation.