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Current Cardiology Reports
Erschienen in: Current Cardiology Reports 3/2024

31.01.2024 | Heart Failure (HJ Eisen, Section Editor)

Combined Heart Kidney Transplantation Versus Heart Transplant in Patients with Renal Failure: Contemporary Insights and Future Perspectives

verfasst von: Anju Bhardwaj, Preethi Pirlamarla, Yevgeniy Brailovsky, Ajith Nair, Indranee Rajapreyar

Erschienen in: Current Cardiology Reports | Ausgabe 3/2024

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Abstract

Purpose of Review

In this review, we aim to outline the criteria regarding the evaluation of patients with chronic renal disease (CKD) awaiting heart transplantation and discuss the outcomes of combined heart/kidney transplantation. Herein, we also review pathophysiology and risk factors that predispose to chronic kidney disease (CKD) and acute kidney injury (AKI) in patients with HF and after OHT.

Recent Findings

In patients with end-stage systolic heart failure (HF) and an estimated glomerular filtration rate (eGFR) < 30 mL/min/1.73 m2, orthotopic heart transplantation (OHT) alone is a relative contraindication, with a consensus that these patients are better served with heart-kidney transplant (HKT). However, there is significant variation between institutions regarding timing and indication for heart/kidney transplantation, with little data available to predict post-transplant outcomes. A Scientific Statement from American Heart Association was published detailing the indications, evaluation, and outcomes for Heart-Kidney Transplantation, and noted a steady rise in the incidence of heart/kidney dual organ transplants. Recently, the Organ Procurement and Transplantation Network (OPTN) Multi-Organ Transplantation Committee implemented a safety net policy for heart transplant recipients who do need meet criteria for simultaneous heart-kidney transplant in 2023 but with a likely need for sequential kidney transplantation.

Summary

Optimization of organ distribution and patient outcomes after cardiac transplantation requires appropriate recipient selection. This review also outlines the criteria regarding the evaluation of patients with CKD awaiting heart transplantation and outcomes of combined HKT.
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Metadaten
Titel
Combined Heart Kidney Transplantation Versus Heart Transplant in Patients with Renal Failure: Contemporary Insights and Future Perspectives
verfasst von
Anju Bhardwaj
Preethi Pirlamarla
Yevgeniy Brailovsky
Ajith Nair
Indranee Rajapreyar
Publikationsdatum
31.01.2024
Verlag
Springer US
Erschienen in
Current Cardiology Reports / Ausgabe 3/2024
Print ISSN: 1523-3782
Elektronische ISSN: 1534-3170
DOI
https://doi.org/10.1007/s11886-023-02017-y

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