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To kidney or not to kidney: Applying lessons learned from the simultaneous liver-kidney transplant policy to simultaneous heart-kidney transplantation.
Clin Transplant. 2020 06; 34(6):e13878.CT

Abstract

As the medical community is increasingly offering transplantation to patients with increasing comorbidity burdens, the number of simultaneous heart-kidney (SHK) transplants is rising in the United States. How to determine eligibility for SHK transplant versus heart transplant alone is unknown. In this review, we situate this problem in the broader picture of organ shortage. We critically appraise available literature on outcomes in SHK versus heart transplant alone. We posit staged kidney-after-heart transplantation as a plausible alternative to SHK transplantation and review the pros and cons. Drawing lessons from the field of simultaneous liver-kidney transplant, we argue for an analogous policy for SHK transplant with standardized minimal eligibility criteria and a modified Safety Net provision. The new policy will serve as a starting point for comparing simultaneous versus staged approaches and refining the medical eligibility criteria for SHK.

Authors+Show Affiliations

Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Palo Alto, California.Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Palo Alto, California.Centura Transplant Center, Denver, Colorado.Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Palo Alto, California.Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Palo Alto, California.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

32279361

Citation

Cheng, Xingxing S., et al. "To Kidney or Not to Kidney: Applying Lessons Learned From the Simultaneous Liver-kidney Transplant Policy to Simultaneous Heart-kidney Transplantation." Clinical Transplantation, vol. 34, no. 6, 2020, pp. e13878.
Cheng XS, Khush KK, Wiseman A, et al. To kidney or not to kidney: Applying lessons learned from the simultaneous liver-kidney transplant policy to simultaneous heart-kidney transplantation. Clin Transplant. 2020;34(6):e13878.
Cheng, X. S., Khush, K. K., Wiseman, A., Teuteberg, J., & Tan, J. C. (2020). To kidney or not to kidney: Applying lessons learned from the simultaneous liver-kidney transplant policy to simultaneous heart-kidney transplantation. Clinical Transplantation, 34(6), e13878. https://doi.org/10.1111/ctr.13878
Cheng XS, et al. To Kidney or Not to Kidney: Applying Lessons Learned From the Simultaneous Liver-kidney Transplant Policy to Simultaneous Heart-kidney Transplantation. Clin Transplant. 2020;34(6):e13878. PubMed PMID: 32279361.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - To kidney or not to kidney: Applying lessons learned from the simultaneous liver-kidney transplant policy to simultaneous heart-kidney transplantation. AU - Cheng,Xingxing S, AU - Khush,Kiran K, AU - Wiseman,Alexander, AU - Teuteberg,Jeffrey, AU - Tan,Jane C, Y1 - 2020/05/07/ PY - 2020/02/02/received PY - 2020/03/27/revised PY - 2020/04/01/accepted PY - 2020/4/13/pubmed PY - 2021/6/24/medline PY - 2020/4/13/entrez KW - allocation KW - heart transplant KW - heart-kidney transplant KW - kidney transplant KW - liver transplant KW - liver-kidney transplant KW - policy SP - e13878 EP - e13878 JF - Clinical transplantation JO - Clin Transplant VL - 34 IS - 6 N2 - As the medical community is increasingly offering transplantation to patients with increasing comorbidity burdens, the number of simultaneous heart-kidney (SHK) transplants is rising in the United States. How to determine eligibility for SHK transplant versus heart transplant alone is unknown. In this review, we situate this problem in the broader picture of organ shortage. We critically appraise available literature on outcomes in SHK versus heart transplant alone. We posit staged kidney-after-heart transplantation as a plausible alternative to SHK transplantation and review the pros and cons. Drawing lessons from the field of simultaneous liver-kidney transplant, we argue for an analogous policy for SHK transplant with standardized minimal eligibility criteria and a modified Safety Net provision. The new policy will serve as a starting point for comparing simultaneous versus staged approaches and refining the medical eligibility criteria for SHK. SN - 1399-0012 UR - https://news.unboundmedicine.com/medline/citation/32279361/To_kidney_or_not_to_kidney:_Applying_lessons_learned_from_the_simultaneous_liver-kidney_transplant_policy_to_simultaneous_heart-kidney_transplantation. DB - PRIME DP - Unbound Medicine ER -