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Kidney transplantation on extracorporeal life support for primary cardiac allograft dysfunction |
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| Authors: | Anthony N. Pham MS Parag C. Patel MD Kevin Landolfo MD Justin M. Burns MD Daniel S. Yip MD Juan C. Leoni Moreno MD Rohan M. Goswami MD Samuel Jacob MD Magdy M. El-Sayed Ahmed MB BCh MD MS Ian A. Makey MD Mathew Thomas MBBS MD Martin L. Mai MD C. Burcin Taner MD Si M. Pham MD |
| Affiliation: | 1. Department of Cardiothoracic Surgery, Mayo Clinic, Jacksonville, Florida;2. Department of Transplantation, Mayo Clinic, Jacksonville, Florida |
| Abstract: | Patients undergoing heart-kidney transplants who have primary graft dysfunction (PGD) of the heart are at risk of losing both organs, which may cause reluctance on the part of the transplant team to proceed with transplanting the kidney while the transplanted heart is being supported by mechanical device. We describe a case series in which 2 patients received kidney transplants while on veno-arterial ECMO support for PGD after heart transplant. Both patients are alive more than 1 year following transplant, with good cardiac and renal function and no signs of cardiac rejection. Kidney transplant surgery is safe for patients on veno-arterial ECMO support for cardiac PGD. It allows the heart recipient to receive a kidney from the same donor with both immunologic and survival advantages. |
| Keywords: | extracorporeal membrane oxygenation heart-kidney transplant kidney transplant primary graft dysfunction |