By Luis Fabregas

Tribune-Review

Transplant surgeons at Allegheny General Hospital hope to perform more combined heart-kidney transplants after their first successful operation on a 63-year-old Pittsburgh man.

The patient, who was not identified, suffered from end-stage heart disease — an illness that severely affected the function of his kidneys. He is recovering at home following the Aug. 30 surgery and no longer must receive daily dialysis treatments, said Dr. Raymond Benza, medical director of the heart-transplant program at the North Side hospital.

Combined heart-kidney transplants are not new but are regaining popularity as doctors develop better techniques and anti-rejection protocols, Benza said. The number of transplants rose to 64 in 2008 from 29 in 2000, according to the United Network for Organ Sharing.

"We can restore the function of the heart much more rapidly, and that results in a good blood flow to the kidneys," Benza explained.

The combined transplant can be an option for heart-disease patients whose kidneys fail. The condition happens frequently because the weakened heart is unable to pump enough blood to the kidneys. Often, the kidneys can be damaged by such conditions as diabetes and hypertension, which are common in heart-disease patients.

Studies have shown that people who receive a combined heart-kidney transplant suffer little rejection of the heart because the immune system tends to focus more on the new kidney, Benza said.

The surgery, however, is not for everyone. Some patients might be too old or have conditions that rule them out for a transplant, said Dr. Stephen Bailey, director of Allegheny General's division of cardiac surgery.

The combined transplant is the first since Allegheny General established its transplantation program in 1987. Bailey and Dr. Ngoc Thai, director of abdominal transplantation, led two teams of surgeons who transplanted the patient's heart first, and then the kidney.

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