Simultaneous Heart and Kidney Transplantation: A Systematic Review and Proportional Meta-Analysis of Its Characteristics and Long-Term Variables

Abstract

Patients with end-stage heart disease who undergo a heart transplant frequently have simultaneous kidney insufficiency, therefore simultaneous heart and kidney transplantation is an option and it is necessary to understand its characteristics and long-term variables. The recipient characteristics and operative and long-term variables were assessed in a meta-analysis. A total of 781 studies were screened, and 33 were thoroughly reviewed. 15 retrospective cohort studies and 376 patients were included. The recipient’s mean age was 51.1 years (95% CI 48.52–53.67) and 84% (95% CI 80–87) were male. 71% (95% CI 59–83) of the recipients were dialysis dependent. The most common indication was ischemic cardiomyopathy [47% (95% CI 41–53)] and cardiorenal syndrome [22% (95% CI 9–35)]. Also, 33% (95% CI 20–46) of the patients presented with delayed graft function. During the mean follow-up period of 67.49 months (95% CI 45.64–89.33), simultaneous rejection episodes of both organ allografts were described in 5 cases only. Overall survival was 95% (95% CI 88–100) at 30 days, 81% (95% CI 76–86) at 1 year, 79% (95% CI 71–87) at 3, and 71% (95% CI 59–83) at 5 years. Simultaneous heart and kidney transplantation is an important option for concurrent cardiac and renal dysfunction and has acceptable rejection and survival rates.