Language

English

Publication Date

11-1-2025

Journal

JHLT Open

DOI

10.1016/j.jhlto.2025.100393

PMID

41234302

PMCID

PMC12604956

PubMedCentral® Posted Date

9-24-2025

PubMedCentral® Full Text Version

Post-print

Abstract

Heart transplantation is regarded as the definitive treatment for advanced pediatric heart failure. However, concomitant kidney dysfunction often complicates candidate selection for isolated heart transplantation. Prolonged venous congestion, nephrotoxic exposures, and recurrent episodes of acute kidney injury can result in varying degrees of renal impairment. Differentiating between reversible kidney injury secondary to cardiorenal syndrome and irreversible intrinsic renal disease remains a major challenge. Pediatric heart-kidney transplantation has shown survival benefits for patients with end-stage heart failure requiring chronic dialysis, yet its role in patients with less severe renal dysfunction is less clearly defined. This review summarizes the current evidence on patient selection, perioperative and post-transplant management, and ethical considerations for pediatric heart-kidney transplantation.

Keywords

Heart kidney transplantation, Heart transplantation, Simultaneous heart kidney transplantation

Published Open-Access

yes

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