INTRODUCTION Combined heart-liver transplantation (CHLT) has resulted in acceptable survival rates compared to orthotopic liver transplantation (OLT) alone and orthotopic heart transplantation alone. Using the US transplant registry, we compared outcomes following sequential and combined HLT. METHODS We conducted a retrospective cohort study. De-identified data were obtained from the United Network Organ Sharing Registry. The primary outcome was patient survival from the date of OLT. Secondary outcomes included liver allograft survival and heart allograft survival. RESULTS The study cohort included 301 CHLT recipients and six sequential heart-liver transplantation (SHLT) recipients. Patient survival after CHLT was 88% at 1 year, 84% at 3 years, and 82% at 5 years compared to 83%, 67%, and 50% in the SHLT group (p = 0.010). Liver allograft survival at 1, 3, and 5 years was 88%,83% and 82%, respectively, in the CHLT group compared to 83% and 67%, and 50%, respectively, in the SHLT group (p = 0.009). After OLT, heart allograft survival at 1, 3, and 5 years was 86%, 79%, and 74% in the CHLT group, respectively, compared to 83%, 67%, and 50% in the SHLT group (p = 0.037). CONCLUSIONS Despite the limited size of the SHLT cohort, we found that CHLT was superior to SHLT in survival rate and graft survival. The better outcomes noted in CHLT may relate to immunoprotection provided by liver transplantation from the same donor.

中文翻译：

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序贯与联合心脏-肝脏移植在美国。

引言与单独的原位肝移植（OLT）和单独的原位心脏移植相比，联合心肝移植（CHLT）导致可接受的生存率。使用美国移植注册中心，我们比较了连续和联合HLT后的结局。方法我们进行了一项回顾性队列研究。从联合网络器官共享注册处获得了身份不明的数据。主要结局是从OLT开始算起的患者生存率。次要结局包括肝脏同种异体移植物存活和心脏同种异体移植物存活。结果该研究队列包括301名CHLT接受者和六名连续心肝移植（SHLT）接受者。CHLT后的患者生存率在1年时为88％，在3年时为84％，在5年时为82％，而SHLT组为83％，67％和50％（p = 0.010）。CHLT组在1年，3年和5年时肝移植存活率分别为88％，83％和82％，而SHLT组分别为83％，67％和50％（p = 0.009） 。OLT后，CHLT组在1、3和5年时心脏异体移植存活率分别为86％，79％和74％，而SHLT组分别为83％，67％和50％（p = 0.037） ）。结论尽管SHLT队列规模有限，但我们发现CHLT在存活率和移植物存活率方面均优于SHLT。CHLT中指出的更好结果可能与同一供体的肝移植提供的免疫保护有关。分别为SHLT组的83％，67％和50％（p = 0.037）。结论尽管SHLT队列规模有限，但我们发现CHLT在存活率和移植物存活率方面均优于SHLT。CHLT中指出的更好结果可能与同一供体的肝移植提供的免疫保护有关。分别为SHLT组的83％，67％和50％（p = 0.037）。结论尽管SHLT队列规模有限，但我们发现CHLT在存活率和移植物存活率方面均优于SHLT。CHLT中指出的更好结果可能与同一供体的肝移植提供的免疫保护有关。