ArticleGlobal cardiology science & practice2026
Combined heart and liver transplantation for homozygous familial hypercholesterolaemia: 35-year post-operative outcomes.
Article in Global cardiology science & practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Combined heart-liver transplantation (CHLT) is an exceptionally rare multi-organ procedure undertaken in patients with concurrent end-stage cardiac and hepatic disease, or in those with inherited metabolic disorders-most notably homozygous familial hypercholesterolaemia (HoFH)-in which defective hepatic LDL receptor (LDL-R) function drives progressive and otherwise irreversible cardiovascular injury. We report a 35-year follow-up of a female patient who underwent simultaneous orthotopic cardiac and liver transplantation on 13 September 1990 for HoFH complicated by severe ischaemic cardiomyopathy and aortic valve stenosis. Pre-operative serum low-density lipoprotein cholesterol (LDL-C) was 13 mmol/L, refractory to all pharmacological interventions available at the time. Transplantation produced immediate normalisation of LDL-C to 2.1 mmol/L, reflecting instantaneous restoration of donor hepatic LDL-R function-consistent with the landmark observations reported by Bilheimer, Goldstein, Brown, and Starzl
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