Korean J Transplant.  2023 Nov;37(Suppl 1):S249. 10.4285/ATW2023.F-8404.

Analysis of status and waiting period of simultaneous transplant (heart-kidney) recipients in single center

• Kim IO
• Hong JJ
• Hwang S
• Kim JJ
• Jung SH
• Kim YH

• KMID: 2551878
• DOI: http://doi.org/10.4285/ATW2023.F-8404

Abstract

Background
Simultaneous heart-kidney transplantation is not only a lifesaving method for end-stage heart and kidney failure patients, but also a treatment method that improves the quality of life. Since Korea's first successful simultaneous heart-kidney transplant in 2005, a total of 45 cases have been performed in Korea to date, of which our hospital has performed 15 simultaneous heart-kidney transplants. The purpose of this study is to determine the status of simultaneous heart-kidney transplant recipients performed at our hospital and provide basic data to patients and medical staff waiting for heart-kidney transplantation.
Methods
In this study, we were retrospectively investigated the general characteristics, emergency level and waiting period at the time of transplant, whether renal replacement therapy was performed, survival after heart-kidney transplant recipients through Korean Network for Organ Sharing (KONOS) statistical annual report and medical records.
Results
Simultaneous heart-kidney transplantation was first performed at our hospital on March 31, 2005, and a total of 15 cases were performed as of January 2023. The gender of transplant recipients was 13 male (86.7%), two female (13.3%) and the blood types were A type (four), AB type (two), B type (two), O type (seven). The average age at the time of transplantation was 52 years (range, 30–65 years) for male and 38.5 years for female (range, 33–44 years). At the time of transplantation, the final heart emergency level was S0 (six), S1 (six), S2 (two) and S3 (one). After the emergency level was raised, the waiting period was heart S0 (16 days), S1 (104 days), S2 (230 days) and S3 (192 days). Before transplantation, only two patients were in predialysis condition with Modification of Diet in Renal Disease of less than 30, and 13 patients were on dialysis using hemodialysis or continuous renal replacement therapy. Two transplant recipients with S0 died during hospitalization due to postoperative bleeding and sepsis. One patient died of septic shock at 8 years 8 months, another died of unknown cause at 10 months, and the other 10 patients are alive without dialysis and within normal heart and renal function ranges.
Conclusions
Since the establishment in of KONOS, the number of domestic heart and kidney transplants and the survival rate have been improved based on accumulated experience. As the waiting period becomes longer, it is more important to provide educational information to maintain optimal health through rehabilitation during the waiting period. It can be used for basic data for transplant waiting management and education. It is considered that it is necessary to supplement the Status scoring system standards comparing additional studies and advanced systems.