Combined heart and kidney transplantation with allografts from the same donor.

We present the cases of 3 patients who underwent simultaneous heart and kidney transplantation using allografts from the same donor. This combined approach offers a reasonable option for patients with coexisting end-stage heart and kidney disease. A review of all previously reported cases suggests that survival is similar to that of single-organ transplantation. In addition, there appears to be a low incidence of rejection when multiple allografts from the same donor are used. The heart and kidney can and frequently do reject asynchronously, so rejection monitoring and surveillance should be carried out separately for each transplanted organ.