Dual-Organ Transplantation: Indications, Evaluation, and Outcomes for Heart-Kidney and Heart-Liver Transplantation

Published: July 13, 2023

human internal organs
  • As a result of complex, bi-directional interactions between heart failure (HF) and kidney disease, kidney dysfunction is prevalent in patients with advanced HF. The presence of acute kidney injury and chronic kidney disease (CKD) is associated with increased mortality risk both pre- and post-heart transplantation (HT).
  • Simultaneous heart-liver transplantation has been associated with a lower risk of rejection than HT alone, and the use of induction immunosuppression is typically on a center-specific basis.
  • Multi-organ transplantation policies can create inequities for patients on transplant waiting lists. Safety Net policies, which prioritize transplantation of a second organ if its function does not recover after a single-organ transplant, may maximize equitable distribution of limited organs.