Solid organ transplantation in heart transplant patients: description of two highly complex cases: a case series.

Background: Heart transplantation has become a developed and routine technique, constituting the treatment of choice in advanced heart failure when other therapies have failed. The number of transplanted patients who require transplantation of another organ in their evolution or simultaneous transplantation is increasing. Experience in this scenario is still limited. Case summary: We present two unusual cases of patients who, after receiving a cardio-bipulmonary transplant and isolated cardiac transplant, respectively, require sequential transplantation of another organ in their evolution. In the first case, as a consequence of immunosuppressive drugs, there is a progressive deterioration of renal function that requires renal transplantation after years of peritoneal dialysis. In the second case, shortly after cardiac transplantation, severe emphysematous chronic obstructive pulmonary disease of quick evolution was diagnosed, requiring one-lung transplantation after needing ambulatory oxygen therapy. The evolutionary complications of both cases are presented. Discussion: Patients with multiple organ transplantation represent a challenge as this situation is less frequent, due to the added difficulties in the adjustment of immunosuppression and the specific complications of each organ. However, multidisciplinary follow-up of these patients has led to improved survival.