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Combined heart and other organ transplants in Spain: Current review of clinical outcomes. COMBI Study

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Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • González-Costello, J.
  • González-Vílchez, F.
  • Bueno, M.G.
  • Grillé, Z.
  • Caravaca-Pérez, P.
  • Belaustegui, M.C.
  • Gonzalez-Martin, J.
  • Molina, B.D.
  • López, L.
  • Rangel-Sousa, D.
  • Blasco, M.T.
  • Crespin, M.
  • Garrido, I.

Grupos

Abstract

Background Combined heart transplantation (HTx) with other organs is an established intervention when both organs fail simultaneously or when a noncardiac organ fails after HTx. This study aimed to describe the Spanish experience with this transplant modality and to analyze survival outcomes. Methods This is a retrospective study based on the Spanish Heart Transplant Registry (1998-2024). Pediatric HTx and patients with previous transplants of other organs were excluded. Patients were classified into isolated HTx (n = 6663), simultaneous combined HTx (n = 147; kidney:60; lung:71; liver:16), and delayed combined HTx (n = 110; kidney:72; hematopoietic stem cells [HSC]:27; liver:10; lung:1). Combined HTx accounted for 3.9% of the total. Results For simultaneous combined procedures, 30-day survival rates were: HTx+kidney: 84%; HTx+liver: 88%; HTx+lung: 73% (p = 0.034); 5-year survival rates were: 64%, 74%, and 41%, respectively (p = 0.0001). In delayed combined HTx, early mortality was low across all types. Five-year survival rates were: HTx+kidney: 73%; HTx+liver: 67%; HTx+HSC: 59% (p = 0.39). An elective isolated HTx showed better results at 10-year survival than combined HTx, both simultaneous and delayed (p = 0.004). Conclusions Combined HTx accounts for around 4% of total HTx. Simultaneous heart-liver transplantation provides the best outcomes, while heart-lung transplantation carries the highest risk. Delayed combined HTx shows good early survival. © 2026 The Authors.

Datos de la publicación

ISSN/ISSNe:
1053-2498, 1557-3117

JOURNAL OF HEART AND LUNG TRANSPLANTATION  ELSEVIER SCIENCE INC

Tipo:
Article
Páginas:
756-767
PubMed:
41581844
Enlace a otro recurso:
www.scopus.com
Factor de Impacto:
2,472 SCImago ℠
Cuartil:
Q1 SCImago ℠

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Keywords

  • Cardiohepatic transplantation; Cardiopulmonary transplantation; Cardiorenal transplantation; Heart-hematopoietic progenitor cell transplantation; Simultaneous and delayed heart transplantation

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