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Year : 2016  |  Volume : 1  |  Issue : 1  |  Page : 3-6

Combined Heart and Liver Transplantation

1 MD, DM, FISC; Department of Cardiology and Department of Pediatric Gastroenterology, Nims University, Jaipur-303121, Rajasthan, India
2 Director - Institute of Pediatric Gastroenterology & Hepatology; Director - Institute of Multi Organ Transplant; Chancellor, Nims University - Rajasthan Jaipur - India 303121, India

Correspondence Address:
Anil Grover
MD, DM, FISC; Department of Cardiology and Department of Pediatric Gastroenterology, Nims University, Jaipur-303121, Rajasthan
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Source of Support: None, Conflict of Interest: None

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Background: With first liver transplantation in 1963 and first heart transplant in 1967, the first combined liver and heart transplantation (CHLT) took another 21 years to occur. Since then these remain rare events. During last 12 years, this set of procedures has been used more frequently as therapeutic modality. This study was taken to critically review the various aspects of this clinical condition. With the technical innovation to undertake liver transplantation during transient heart failure has made CHLT possible. Methods/Results: We performed a thorough research of Pubmed/Medline, gathering data regarding situations where CHLT have been performed over last 25 years. This data were discussed to build to better understanding and build consensus about indications for this procedure in this era of organ scarcity. Conclusions: Combined heart liver transplantation is a viable therapy for patients with end stage heart and liver failure. This is specially so in patients with end stage liver disease who are unable to tolerate orthotopic liver transplant(OLT) post operatively due to cardiac dysfunction. Answer to the question that can giving two organs to a single individual in CHLT is justified? As evident from literature among all who received one thoracic one abdominal organ simultaneously, only CHLT recipients have shown greater survival benefits. CHLT is a safe and effective procedure, with combined graft survival rates similar to isolated heart and isolated liver transplantation. National organ donation registry of a country should formulate its own individual criteria for wait listing and prioritization; as technical expertise and resources vary from one nation to other; so do the organ availability and the statutes of law.

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