Arq. Bras. Cardiol. 2024; 121(7): e20240007
Staged Heart-Kidney Transplantation with Renal Pulsatile Preservation: A Viable Approach for Combined Transplantation
Arthur Gus Manfro
, Rodrigo Fontanive Franco
, Roberto Ceratti Manfro, Nadine Clausell
, Livia Adams Goldraich
Introduction
Isolated heart and kidney transplants have become routine procedures for addressing end-stage organ failure. Notably, renal dysfunction is frequently observed in patients with advanced heart failure (HF), significantly impacting the prognosis of heart transplantation. Conversely, advanced HF is common in patients with end-stage renal disease (ESRD), often impairing kidney transplantation. Consequently, many centers are adopting combined heart and kidney transplantation (HKTx) as the standard of care for those patients. The progress in this field has led to a substantial increase in multiorgan transplants over the last decade. Despite the growth in HKTx, uncertainties persist regarding the preferred surgical sequence. In Brazil, while a significant number of isolated heart and kidney transplants are performed annually, only a few combined HKTx have been documented., Considering the advancements in the field, it is anticipated that combined transplants will become more commonplace shortly. Here, we present a case report of a staged HKTx with renal pulsatile perfusion preservation.
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