SUCCESSFUL COMBINED LIVER-HEART TRANSPLANTATION IN ADULTS: REPORT OF THREE PATIENTS AND REVIEW OF THE LITERATURE
- 1 November 1999
- journal article
- case report
- Published by Ovid Technologies (Wolters Kluwer Health) in Transplantation
- Vol. 68 (9), 1423-1427
- https://doi.org/10.1097/00007890-199911150-00034
Abstract
Three patients received liver/heart transplantation, and we report their successful outcome. Two patients had alcoholic cirrhosis and dilated cardiomyopathy; one had cryptogenic liver disease and idiopathic cardiomyopathy. All patients had evidence of portal hypertension and coagulopathy. The cardiac transplants were performed first. Cardiopulmonary bypass was discontinued in favor of venovenous bypass, and liver transplantation was then performed. All patients developed acute tubular necrosis; two required a brief period of hemodialysis. There was only one episode of acute cellular rejection of the liver. Protocol endomyocardial biopsies in all three patients revealed no evidence of rejection. All patients are currently using low doses of immunosuppressive medications and have normal liver chemistry tests and cardiac function; two patients have mild renal insufficiency. In selected patients with severe cardiac dysfunction and advanced liver disease, liver/heart transplantation can be successfully performed even in the face of portal hypertension and coagulopathy.Keywords
This publication has 8 references indexed in Scilit:
- Advantages of inferior vena caval flow preservation in combined transplantation of the liver and heartTransplant International, 1997
- Primary liver cancer and survival in patients undergoing liver transplantation for hemochromatosisLiver Transplantation and Surgery, 1995
- Orthotopic liver transplantation for hepatic-based metabolic disordersTransplant International, 1995
- A Comparison of Tacrolimus (FK 506) and Cyclosporine for Immunosuppression in Liver TransplantationNew England Journal of Medicine, 1994
- Combined Liver and Heart Transplantation for End-Stage Iron-Induced Organ Failure in an Adult with Homozygous Beta-ThalassemiaNew England Journal of Medicine, 1994
- Combined Transplantation of the Heart and LiverAnnals of Surgery, 1985
- INCIDENCE AND PROGNOSTIC IMPORTANCE OF JAUNDICE AFTER CARDIOPULMONARY BYPASS SURGERYThe Lancet, 1983
- Transection of the oesophagus for bleeding oesophageal varicesBritish Journal of Surgery, 1973