Cardiac Surgery at the Time of Simultaneous Liver-Kidney Transplantation

James M. Tatum, Adrienne M. Quinn, Yuri S. Genyk, Linda S. Sher, Lea K. Matsuoka, Amy E. Hackman, Sophoclis P. Alexopoulos, Mark L. Barr, Michael E. Bowdish, Mark J. Cunningham

Abstract


Cardiac valve disease is often a contraindication to liver or simultaneous liver-kidney transplantation. The risk of heart surgery in these patients is extremely high, yet uncorrected valve disease jeopardizes transplantation outcomes. Two cases of combined aortic valve replacement at the time of simultaneous liver-kidney transplantation, with 2-month and 3-year postoperative follow-ups, are discussed. Both patients survived surgery and were discharged with good allograft and heart function. At last follow-up, neither experienced graft failure or valve dysfunction, although one patient did develop type 1B rejection of his kidney allograft. In appropriate cases, surgical correction of structural heart disease can be performed at the time of complex abdominal organ transplantation, accomplishing both otherwise contraindicated procedures.




J Curr Surg. 2016;6(1):37-40
doi: http://dx.doi.org/10.14740/jcs300w


Keywords


Simultaneous liver-kidney transplant; Cardiac surgery; Liver transplantation

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