Revista ABCd (São Paulo). 24 Jun, 2022

COMBINED HEART-LIVER-KIDNEY TRANSPLANTATION: THE FIRST EXPERIENCE IN LATIN AMERICA

Eduardo FERNANDES
Filipe Roza da SILVA
Rodrigo SEGALOTE
Pedro Túlio ROCHA
Felipe MELLO
Camila GIRÃO
Ronaldo OLIVEIRA
Leandro SAVATTONE
Camila CESAR
Munique SIQUEIRA
Adolpho BAAMONDE
Gabrielle OLIVEIRA
Rodrigo FURTADO
Thays RIBEIRO
Carlos GALHARDO
Camila TOBIAS
Gabriel MOURAD
Felipe ROBALINHO
Anderson BRITO
DOI: 10.1590/0102-672020210002e1668

INTRODUCTION

Multiorgan dysfunction involving the liver and kidneys is common in patients with end-stage heart failure. The first combined liver-kidney transplant (CLKT) was performed by Margreiter in 1983, and it is a routine procedure in many transplant centers representing 1-8% of liver transplant candidates5.

Hepatic and renal dysfunction may be secondary to a systemic disease process affecting the heart, liver, and kidneys or may be a consequence of heart failure with venous congestion and arterial hypoperfusion2,4.

Despite the complexity and costs involved, the results of this type of transplant are optimistic, as these are terminally ill patients.

Our objective was to report the first Latin American experience in triple transplantation in the same surgical time (heart, liver, and kidney), which took place at Hospital São Lucas Copacabana1.

Case Report

The organ receiver was a 56-year-old male, physical education teacher, diagnosed with dilated cardiomyopathy with biventricular dysfunction of undetermined origin and compensated cirrhosis of probable cardiogenic etiology diagnosed in 2018 during a cholecystectomy. Chronic kidney disease was due to cardiorenal syndrome.

After follow-up of the case, triple liver-cardiac-renal transplantation was indicated.


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