Sequential Versus Combined Heart-Liver Transplantation in the USA.

Abstract:

INTRODUCTION:Combined heart-liver transplantation (CHLT) has resulted in acceptable survival rates compared to orthotopic liver transplantation (OLT) alone and orthotopic heart transplantation alone. Using the US transplant registry, we compared outcomes following sequential and combined HLT. METHODS:We conducted a retrospective cohort study. De-identified data were obtained from the United Network Organ Sharing Registry. The primary outcome was patient survival from the date of OLT. Secondary outcomes included liver allograft survival and heart allograft survival. RESULTS:The study cohort included 301 CHLT recipients and six sequential heart-liver transplantation (SHLT) recipients. Patient survival after CHLT was 88% at 1 year, 84% at 3 years, and 82% at 5 years compared to 83%, 67%, and 50% in the SHLT group (p = 0.010). Liver allograft survival at 1, 3, and 5 years was 88%,83% and 82%, respectively, in the CHLT group compared to 83% and 67%, and 50%, respectively, in the SHLT group (p = 0.009). After OLT, heart allograft survival at 1, 3, and 5 years was 86%, 79%, and 74% in the CHLT group, respectively, compared to 83%, 67%, and 50% in the SHLT group (p = 0.037). CONCLUSIONS:Despite the limited size of the SHLT cohort, we found that CHLT was superior to SHLT in survival rate and graft survival. The better outcomes noted in CHLT may relate to immunoprotection provided by liver transplantation from the same donor.

journal_name

Dig Dis Sci

authors

Yamaguchi Y,Burrier C,Roth C,Tumin D,Beal EW,Washburn K,Hayes D Jr,Tobias JD

doi

10.1007/s10620-019-05958-z

subject

Has Abstract

pub_date

2020-08-01 00:00:00

pages

2427-2432

issue

8

eissn

0163-2116

issn

1573-2568

pii

10.1007/s10620-019-05958-z

journal_volume

65

pub_type

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