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Ventricular-Assist Devices and Kidney Disease pp 177–186Cite as

Patient Selection for Combined Heart and Kidney Transplantation

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Abstract

There are no published guidelines to help make decisions on which patients will benefit from combined heart–kidney transplant (CHKT) versus heart transplant alone (HTA). Listing criteria are largely center-specific. Optimizing organ allocation and patient outcomes after CHKT require a close multidisciplinary team approach. This review focuses on evaluation of kidney function in the setting of advanced HF and understanding criteria for CHKT.

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Abbreviations

AKI:

Acute kidney injury

CHKT:

Combined heart–kidney transplant

CKD:

Chronic kidney disease

CrCl:

Creatinine clearance

ESRD:

End stage renal disease

GFR:

Glomerular filtration rate

HTA:

Heart transplant alone

LVAD:

Left ventricular assist device

RI:

Renal insufficiency

References

  1. Smith GL, Lichtman JH, Bracken MB, Shlipak MG, Phillips CO, DiCapua P, Krumholz HM. Renal impairment and outcomes in heart failure: systematic review and meta-analysis. J Am Coll Cardiol. 2006;47(10):1987.

    Article  PubMed  Google Scholar 

  2. Ezekowitz J, McAlister FA, Humphries KH, Norris CM, Tonelli M, Ghali WA, Knudtson ML, APPROACH Investigators. The association among renal insufficiency, pharmacotherapy, and outcomes in 6,427 patients with heart failure and coronary artery disease. J Am Coll Cardiol. 2004;44(8):1587.

    Article  PubMed  Google Scholar 

  3. Heywood JT, Fonarow GC, Costanzo MR, Mathur VS, Wigneswaran JR, Wynne J, ADHERE Scientific Advisory Committee and Investigators. High prevalence of renal dysfunction and its impact on outcome in 118,465 patients hospitalized with acute decompensated heart failure. J Card Fail. 2007;13(6):422.

    Article  PubMed  Google Scholar 

  4. Bock JS, Gottlieb SS. Cardiorenal syndrome: new perspectives. Circulation. 2010;121(23):2592.

    Article  PubMed  Google Scholar 

  5. de Silva R, Nikitin NP, Witte KK, Rigby AS, Goode K, Bhandari S, Clark AL, Cleland JG. Incidence of renal dysfunction over 6 months in patients with chronic heart failure due to left ventricular systolic dysfunction: contributing factors and relationship to prognosis. Eur Heart J. 2006;27(5):569.

    Article  CAS  PubMed  Google Scholar 

  6. McAlister FA, Ezekowitz J, Tonelli M, Armstrong PW. Renal insufficiency and heart failure: prognostic and therapeutic implications from a prospective cohort study. Circulation. 2004;109(8):1004.

    Article  PubMed  Google Scholar 

  7. Vossler MR, Ni H, Toy W, Hershberger RE. Pre-operative renal function predicts development of chronic renal insufficiency after orthotopic heart transplantation. J Heart Lung Transplant. 2002;21:874–81.

    Article  PubMed  Google Scholar 

  8. Al Aly Z, Abbas S, Moore E, Diallo O, Hauptman PJ, Bastani B. The natural history of renal function following orthotopic heart transplant. Clin Transpl. 2005;19:683–9.

    Article  Google Scholar 

  9. Camlaou T, et al. Combined heart-kidney transplant improves post-transplant survival compared with isolated heart transplant in recipients with reduced glomerular filtration rate: analysis of 593 combined heart-kidney transplants from the United Network Organ Sharing Database. Thorac Cardiovasc Surg. 2014 Jan;147(1):456–61.

    Article  Google Scholar 

  10. Odim J, Wheat J, Laks H, et al. Peri-operative renal function and outcome after orthotopic heart transplantation. J Heart Lung Transplant. 2006;25:162–6.

    Article  PubMed  Google Scholar 

  11. Kobashigawa JA, Starling RC, Mehra MR, et al. Multicenter retrospective analysis of cardiovascular risk factors affecting long-term outcome of de novo cardiac transplant recipients. J Heart Lung Transplant. 2006;25:1063–9.

    Article  PubMed  Google Scholar 

  12. Senechal M, Dorent R, du Montcel ST, et al. End-stage renal failure and cardiac mortality after heart transplantation. Clin Transpl. 2004;18:1–6.

    Article  Google Scholar 

  13. Czer LSC, Ruzza A, Vespignani R, Jordan S, De Robertis MA, Mirocha J, et al. Survival and allograft rejection rates after combined heart and kidney transplantation in comparison with heart transplantation alone. Transplant Proc. 2011;43:3869–76.

    Article  CAS  PubMed  Google Scholar 

  14. Laufner G, Kocher A, Grabenwoger M, Berlakovich GA, Zuckermann A, Ofner P, et al. Simultaneous heart and kidney transplantation as treatment for end-stage heart and kidney failure. Transplantation. 1997;64:1129–34.

    Article  Google Scholar 

  15. Combined heart and kidney transplantation provides an excellent survival and decreases risk of cardiac cellular rejection and coronary allograft vasculopathy. Transplant Proc. 2011;43(5):1871–6.

    Google Scholar 

  16. Blanche C, Valenza M, Czer LS, Barath P, Admon D, Harasty D. Combined heart and kidney transplantation with allografts from the same donor. Ann Thorac Surg. 1994;58:1135.

    Article  CAS  PubMed  Google Scholar 

  17. Kabschull L, Schleicher C, Palmes D, Sindermann J, Suwelack B, Senninger N. Renal graft outcome in combined heart-kidney transplantation compared to kidney transplantation alone: a single-center, matched-control study. Thorac Cardiovasc Surg. 2012;60:57–63.

    Article  Google Scholar 

  18. Norman JC, Brook MI, Cooley DA, et al. Total support of the circulation of a patient with post-cardiotomy stone-heart syndrome by a partial artificial heart (ALVAD) for 5 days followed by heart and kidney transplantation. Lancet. 1978;27:1125–7.

    Article  Google Scholar 

  19. The registry of the International Society for Heart and Lung Transplantation: thirty-second official adult heart transplantation report—2015. J Heart Lung Transplant. 2015;34(10):124.

    Google Scholar 

  20. Jessup M, Abraham WT, Casey DE, et al. 2009 focused update: ACCF/AHA guidelines for the diagnosis and management of heart failure in adults: a report of the American college of cardiology foundation/american heart association task force on practice guidelines: developed in collaboration with the international society for heart and lung transplantation. Circulation. 2009;119:1977–2016.

    Article  PubMed  Google Scholar 

  21. Suthanthiran M, Strom TB. Renal transplantation. N Engl J Med. 1994;331(6):365.

    Article  CAS  PubMed  Google Scholar 

  22. Wolfe RA, Ashby VB, Milford EL, Ojo AO, Ettenger RE, Agodoa LY, Held PJ, Port FK. Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. N Engl J Med. 1999;341(23):1725.

    Article  CAS  PubMed  Google Scholar 

  23. Ojo A, Wolfe RA, Agodoa LY, Held PJ, Port FK, Leavey SF, Callard SE, Dickinson DM, Schmouder RL, Leichtman AB. Prognosis after primary renal transplant failure and the beneficial effects of repeat transplantation: multivariate analyses from the United States Renal Data System. Transplantation. 1998;66(12):1651.

    Article  CAS  PubMed  Google Scholar 

  24. Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P. Acute renal failure—definition, outcome measures, animal models, fluid therapy and information technology needs: The Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care. 2004;8:R204–12.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Mehta RL, Kellum JA, Shah SV, et al. Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care. 2007;11:R31.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron. 1976;16:31–41.

    Article  CAS  PubMed  Google Scholar 

  27. Manjunath G, Sarnak MJ, Levey AS. Prediction equations to estimate glomerular filtration rate: an update. Curr Opin Nephrol Hypertens. 2001;10:785–92.

    Article  CAS  PubMed  Google Scholar 

  28. Poole SG, Dooley MJ, Rischin D. A comparison of bedside renal function estimates and measured glomerular filtration rate (Tc99mDTPA clearance) in cancer patients. Ann Oncol. 2002;13:949–55.

    Article  CAS  PubMed  Google Scholar 

  29. Luke DR, Halstenson CE, Opsahl JA, Matzke GR. Validity of creatinine clearance estimates in the assessment of renal function. Clin Pharmacol Ther. 1990;48(5):503–8.

    Article  CAS  PubMed  Google Scholar 

  30. Smilde TDJ, van Veldhuisen DJ, Navis G, et al. Drawbacks and prognostic value of formulas estimating renal function in patients with chronic heart failure and systolic dysfunction. Circulation. 2006;114:1572–80.

    Article  PubMed  Google Scholar 

  31. Apperloo AJ, de Zeeuw D, Donker AJ, de Jong PE. Precision of glomerular filtration rate determinations for long-term slope calculations is improved by simultaneous infusion of 125I- iothalamate and 131I-hippuran. J Am Soc Nephrol. 1996;7:567–72.

    PubMed  CAS  Google Scholar 

  32. Moghazi S, Jones E, Schroepple J, Arya K, McClellan W, et al. Correlation of renal histopathology with sonographic findings. Kidney Int. 2005;67:1515–20.

    Article  PubMed  Google Scholar 

  33. Manley JA, O’Neill WC. How echogenic is echogenic? Quantitative acoustics of the renal cortex. Am J Kidney Dis. 2001;37:706–11.

    Article  CAS  PubMed  Google Scholar 

  34. Makusidi MA, Chijioke A, Braimoh KT, Aderibigbe A, Olanrewaju TO, Liman HM. Usefulness of renal length and volume by ultrasound in determining severity of chronic kidney disease. Saudi J Kidney Dis Transpl. 2014;25(5):1117–21.

    Article  PubMed  Google Scholar 

  35. Moghazi S, Jones E, Schroepple J, Arya K, McClellan W, Hennigar RA, O’Neill WC. Correlation of renal histopathology with sonographic findings. Kidney Int. 2005;67(4):1515.

    Article  PubMed  Google Scholar 

  36. O’Neill WC. Sonographic evaluation of renal failure. Am J Kidney Dis. 2000;35:1021–38.

    Article  PubMed  Google Scholar 

  37. Perez-Rodriguez J, Lai S, Ehst BD, Fine DM, Bluemke DA. Nephrogenic systemic fibrosis: incidence, associations, and effect of risk factor assessment—report of 33 cases. Radiology. 2009;250(2):371–7.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Broome DR, Girguis MS, Baron PW, Cottrell AC, Kjellin I, Kirk GA. Gadodiamide-associated nephrogenic systemic fibrosis: why radiologists should be concerned. AJR Am J Roentgenol. 2007;188(2):586.

    Article  PubMed  Google Scholar 

  39. Song HY, Hwang JH, Noh H, et al. The prevalence and associated risk factors of renal artery stenosis in patients undergoing cardiac catheterization. Yonsei Med J. 2000;41:219–25.

    Article  CAS  PubMed  Google Scholar 

  40. Uzu T, Inoue T, Fujii T, et al. Prevalence and predictors of renal artery stenosis in patients with myocardial infarction. Am J Kidney Dis. 1997;29:733–8.

    Article  CAS  PubMed  Google Scholar 

  41. Labban B, Crew RJ, Cohen DJ. Combined heart-kidney transplantation: a review of recipient selection and patient outcomes. Adv Chronic Kidney Dis. 2009;16(4):288–96.

    Article  PubMed  Google Scholar 

  42. Labban B, Arora N, Restaino S, Markowitz G, Valeri A, Radhakrishnan J. The role of kidney biopsy in heart transplant candidates with kidney disease. Transplantation. 2010;89:887–93.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Advocate Christ Medical Center, University of Illinois, Oak Lawn, IL, USA

    Chaitanya Desai

  2. Southwest Nephrology Associates, Evergreen Park, IL, USA

    Chaitanya Desai

Authors
  1. Chaitanya Desai
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Corresponding author

Correspondence to Chaitanya Desai .

Editor information

Editors and Affiliations

  1. Director, Nephrology, Solid Organ Transplantation and Advanced Heart Failure Therapies, Advocate Christ Medical Center, University of Illinois, Oak Lawn, Illinois, USA

    Chaitanya Desai

  2. Clinical Associate Professor of Medicine University of Illinois, Clinical Director, Heart Transplantation and Mechanical Assistance, Advocate Christ Medical Center, Oak Lawn, Illinois, USA

    William G. Cotts

  3. Clinical Professor of Medicine, Section of Nephrology, University of Illinois at Chicago, College of Medicine, Advocate Christ Medical Center, Oak Lawn, Illinois, USA

    Edgar V. Lerma

  4. Associate Professor of Medicine, Division of Nephrology, Department of Medicine, Penn Presbyterian Medical Cente, Perleman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA

    Michael R. Rudnick

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Desai, C. (2018). Patient Selection for Combined Heart and Kidney Transplantation. In: Desai, C., Cotts, W., Lerma, E., Rudnick, M. (eds) Ventricular-Assist Devices and Kidney Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-74657-9_12

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  • DOI: https://doi.org/10.1007/978-3-319-74657-9_12

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-74656-2

  • Online ISBN: 978-3-319-74657-9

  • eBook Packages: MedicineMedicine (R0)

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