Life-Saving Combined Heart–Kidney Transplantation in a Previous Sequential Heart and Kidney Transplant Recipient

PURPOSE: Solid organ re-transplantation in the context of allograft failure is a challenging clinical and ethical problem. Ideally, solid organ re-transplantation after initial allograft failure should be performed in all recipients, but this is often not clinically or logistically feasible. METHODS: This report details what we believe is the first combined heart–kidney transplant in a recipient of a previous sequential heart and kidney transplant. RESULTS: Eight years after a combined heart and kidney transplant after initially receiving a sequential heart and kidney transplant, a 31-year-old man is doing extremely well, with no rejection episodes or significant complications after transplantation. SUMMARY: This case confirms that combined heart and kidney transplantation is a viable option for tackling the complex issue of graft failure in recipients of previous cardiac and renal grafts. LEARNING POINTS: Good short- and long-term outcomes following combined heart–kidney transplantation can be achieved in patients with multi-system end-organ dysfunction. Advances in immunosuppressant therapy have enabled multiple transplantation procedures from different donors in a single recipient. We describe the first recipient in the world of combined heart–kidney transplantation on a background of previous sequential heart–kidney transplantation.