Rare Combined Heart and Kidney Transplant in a Pediatric Patient: A Case Study

Journal of Transplant Coordination, Vol. 9, Number 3, September 1999 sequencing of the procedures generally called for renal grafting to follow the cardiac transplant as soon as hemodynamic stability was achieved. Adequate cardiac output would then provide necessary perfusion to the kidney; with the sequential procedures minimizing ischemic times. Combined heart and kidney transplant has several theoretical advantages. The recipient is exposed to only 1 set of alloantigens, thus reducing the likelihood of rejection. It is postulated, from clinical and animal models, that there is a protective mechanism in patients receiving multiple allografts from the same donor.6,11,12,14-16 Also, the patient is subjected to only 1 general anesthesia and hospitalization at the time of surgery. Results of CHKT are similar to isolated heart and kidney transplants.8,12,14-17 Rejection must be monitored in both organs because they can reject asynchronously.3,6,8,12-16,18 The experience with CHKT in children has not been well documented. In one multicenter report, clinical outcomes are described in 82 CHKT recipients ranging in age from 8 to 65 years, but the pediatric recipient results are not discussed.14 Only 3 reported cases exist of CHKT in patients aged 17 years or younger.11,17,18 Livesey et al18 performed a CHKT in a 17-year-old adolescent boy with familial dilated cardiomyopathy and nonspecific glomerulonephritis. Savdie et al11 performed the procedure on Rare combined heart and kidney transplant in a pediatric patient: a case study