Abstract
PurposeThe purpose of this study is to evaluate patient outcomes of simultaneous triple organ transplants, which may provide insight for optimal donor allocation while also maximizing recipient benefit. MethodsTriple organ transplants and their corollary dual organ transplants were identified using the UNOS database. Triple organ transplants evaluated included heart-lung-kidney (n=12) and heart-liver-kidney (n=37). Heart-lung-kidney recipients were compared to heart-lung (n=325), lung-kidney (n=91) and heart-kidney (n=2022) groups. Heart-liver-kidney recipients were compared to heart-liver (n=451), liver-kidney (n=10422), and heart-kidney (n=2517). Patient survival outcomes were calculated using the Kaplan–Meier method and compared using log-rank tests. ResultsPatients undergoing triple organ transplant showed similar 10-year survival to their corresponding dual organ cohorts. Patient survival estimate at 10 years for the heart-lung-kidney group was 45%, with no statistically significant difference in survival when compared to dual organ groups (p=0.16). Survival estimate at 10 years for the heart-liver-kidney group was 49.4%, with no statistically significant difference in survival when compared to dual organ groups (p = 0.06). ConclusionDespite the surgical burden of adding a third organ transplant, heart-liver-kidney and heart-lung-kidney have similar survival outcomes to their dual organ equivalents and represent a reasonable allocation option in well-selected patients.
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