[Combined heart-kidney transplantation in Mexic]. / Trasplante combinado de corazón-riñón en México.

BACKGROUND: In our country, heart and kidney transplantation is a novel option for treatment of combined terminal heart and kidney failure. This program began in 2012 for selected patients with documented terminal heart failure and structural kidney damage with renal failure. Description of cases: Between January 1, 2012 and April 30, 2016, we made 92 orthotopic heart transplantations. In five of these cases the heart transplantation was combined with kidney transplantation. RESULTS: There were three male and two female patients with a mean age 25.6 ± 5.2 years (range, 17-29). The patients improved their renal function and the heart transplantation was successful with an improved quality of life. One patient died from abdominal sepsis. The other patients are doing well. CONCLUSION: The combined heart-kidney transplantation is a safe and efficient procedure for patients with structural kidney and heart damage as a cause of terminal failure.

[Experience in liver transplantation (1996-2011) at the UMAE, General Hospital Gaudencio González Garza, National Medical Center La Raza, Mexican Institute of Social Security, Mexico City, D.F]. / Experiencia en trasplante hepático (1996-2011) en la UMAE, Hospital General Gaudencio González Garza, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, México, D.F.

We present the experience of General Hospital CMN La Raza from 1996 to 2011. In this period, we have made 40 liver transplants in adults and 22 pediatric liver transplants. A 100% of adult population received a graft from deceased donor; while in the pediatric age group, 60% were from deceased donor and 40% from living donor. The long-term follow-up is shown only for adult group due to lack of data in the pediatric group. The mean age for the adult group is 42 years old and 4.5 years for the pediatric group. The main indications for liver transplantation in adults were: cirrhosis due to chronic hepatitis C in 47.5% and cirrhosis due to alcohol abuse in 15% of the group. In the pediatric group was more likely the biliary atresia (60%) as an indication for liver transplantation followed by fulminant hepatitis (15%). We show the evolution of the hepatectomy's technique in the adult group: it was initially using conventional technique and later it changed to preservation of cava vein (Piggy Back). In the same way, the reconstruction of the bile-duct was initially made using a T-tube stenting and currently, we use end to end bile-duct reconstruction. The patient's survival at 1, 5, and 10 years was 41.5, 27.2, and 13.6%, respectively; with a median of global survival of 6.2 months. Long-term patient's survival has improved after 2004 compared to previous period.