{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:51:11Z","timestamp":1753876271275,"version":"3.41.2"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2023,9,28]],"date-time":"2023-09-28T00:00:00Z","timestamp":1695859200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"National Natural Science Fund for Distinguished Young Scholars of China","award":["82125004"],"award-info":[{"award-number":["82125004"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Multi-organ transplantation has emerged as a viable treatment strategy for patients afflicted with multiple organ failure or significant organ dysfunctions. Despite the promising therapeutic outcomes, this approach also amplifies the risk of organ rejection, infection, or neoplastic growth. We present a unique case of a patient who sequentially underwent liver, kidney, and heart transplantation, all sourced from different donors. This case brings forth intriguing possibilities about the interplay between cardiovascular diseases and complications arising post-transplantation, thereby enriching our understanding of comprehensive transplant immunomodulation and cardiovascular disease prevention.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 59-year-old male with chronic alcohol misuse developed liver cirrhosis in 2012 and subsequent kidney failure in 2018 due to alcoholic liver disease, type II diabetes, hyperlipidaemia, and severe hypertension. Subsequently, an incident of extensive transmural myocardial infarction (Killip III) warranted a heart transplant in 2022. Post-transplant, the patient was maintained on a standard immunosuppression regimen with regular post-operative follow-ups. No signs of rejection were noted 1-year post-final transplantation under standard immunosuppression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>The presented case exemplifies the potential and feasibility of sequential multi-organ transplantation. The multifaceted interplay between the transplanted organs and the immunosuppressive pharmaceuticals likely exert distinct influences on transplantation immune regulation, possibly diverging from the dynamics observed in single-organ transplantation. A comprehensive exploration of the mechanisms governing immune responses in the context of multi-organ transplantation could yield valuable insights for mitigating graft dysfunction. Furthermore, the rapid progression of atherosclerosis observed after liver and kidney transplantation necessitates further scrutiny to elucidate potential correlations with the post-transplantation state.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytad472","type":"journal-article","created":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T21:01:27Z","timestamp":1695848487000},"source":"Crossref","is-referenced-by-count":0,"title":["Sequential transplantation of the liver\u2013kidney\u2013heart from different donors: a case report"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1833-9494","authenticated-orcid":false,"given":"Liaoran","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Organ Transplantation, The Second Affiliated Hospital of Hainan Medical University , 368 Yehai Ave., Haikou, Hainan 570311 , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4844-3867","authenticated-orcid":false,"given":"Yu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory of Preclinical Research and Evaluation for Cardiovascular Implant Materials, Animal Experimental Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , No. 167 North Lishi Road, Xicheng District , Beijing 100037, China"},{"name":"The Cardiomyopathy Research Group at Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases , Fengcunxili, Yongding Town, Mentougou District, Beijing 102308 , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4164-6433","authenticated-orcid":false,"given":"Hang","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Vascular Surgery Intensive Care Unit, The Second Affiliated Hospital of Hainan Medical University , 368 Yehai Ave., Haikou, Hainan 570311 , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9488-7823","authenticated-orcid":false,"given":"Jiangping","family":"Song","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory of Preclinical Research and Evaluation for Cardiovascular Implant Materials, Animal Experimental Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , No. 167 North Lishi Road, Xicheng District , Beijing 100037, China"},{"name":"The Cardiomyopathy Research Group at Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases , Fengcunxili, Yongding Town, Mentougou District, Beijing 102308 , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Organ Transplantation, The Second Affiliated Hospital of Hainan Medical University , 368 Yehai Ave., Haikou, Hainan 570311 , China"},{"name":"The Transplantation Institute of Hainan , 368 Yehai Ave., Haikou, Hainan 570311 , China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,9,28]]},"reference":[{"key":"2023101711190819000_ytad472-B1","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/S0140-6736(87)90765-3","article-title":"Transplantation of liver, heart, and lungs for primary biliary cirrhosis and primary pulmonary hypertension","volume":"2","author":"Wallwork","year":"1987","journal-title":"Lancet"},{"key":"2023101711190819000_ytad472-B2","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1016\/S0140-6736(01)06003-2","article-title":"Combined transplantation of the heart, lung, and liver","volume":"358","author":"Praseedom","year":"2001","journal-title":"Lancet"},{"key":"2023101711190819000_ytad472-B3","doi-asserted-by":"crossref","first-page":"e415","DOI":"10.1097\/TXD.0000000000000854","article-title":"Simultaneous versus sequential heart-liver transplantation: ideal strategies for organ allocation","volume":"5","author":"Rucker","year":"2019","journal-title":"Transplant Direct"},{"key":"2023101711190819000_ytad472-B4","first-page":"157","article-title":"HLA typing and its influence on organ transplantation","volume":"333","author":"Sheldon","year":"2006","journal-title":"Methods Mol Biol"},{"key":"2023101711190819000_ytad472-B5","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1016\/j.ejcts.2010.03.009","article-title":"Simultaneous cardiac and renal transplantation late after hepatic transplantation","volume":"38","author":"Pinto","year":"2010","journal-title":"Eur J Cardiothorac Surg"},{"key":"2023101711190819000_ytad472-B6","doi-asserted-by":"crossref","first-page":"1331","DOI":"10.1016\/j.jacc.2021.01.013","article-title":"Heart-after-liver transplantation attenuates rejection of cardiac allografts in sensitized patients","volume":"77","author":"Daly","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"2023101711190819000_ytad472-B7","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1146\/annurev.immunol.021908.132629","article-title":"The liver as a lymphoid organ","volume":"27","author":"Crispe","year":"2009","journal-title":"Annu Rev Immunol"},{"key":"2023101711190819000_ytad472-B8","doi-asserted-by":"crossref","first-page":"3615","DOI":"10.4049\/jimmunol.177.6.3615","article-title":"Liver sinusoidal endothelial cells that endocytose allogeneic cells suppress T cells with indirect allospecificity","volume":"177","author":"Tokita","year":"2006","journal-title":"J Immunol"},{"key":"2023101711190819000_ytad472-B9","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1084\/jem.20020827","article-title":"Peripheral deletion of autoreactive CD8 T cells by cross presentation of self-antigen occurs by a Bcl-2-inhibitable pathway mediated by Bim","volume":"196","author":"Davey","year":"2002","journal-title":"J Exp Med"},{"key":"2023101711190819000_ytad472-B10","doi-asserted-by":"crossref","first-page":"1580","DOI":"10.1111\/ajt.13131","article-title":"Kidney-induced cardiac allograft tolerance in miniature swine is dependent on MHC-matching of donor cardiac and renal parenchyma","volume":"15","author":"Madariaga","year":"2015","journal-title":"Am J Transplant"},{"key":"2023101711190819000_ytad472-B11","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1001\/archsurg.2011.101","article-title":"Transplant tolerance: bench to bedside\u201426th annual Samuel Jason Mixter Lecture","volume":"146","author":"Sachs","year":"2011","journal-title":"Arch Surg"},{"key":"2023101711190819000_ytad472-B12","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1111\/j.1399-3046.2010.01436.x","article-title":"Donor specific antibodies after transplantation","volume":"15","author":"Platt","year":"2011","journal-title":"Pediatr Transplant"},{"key":"2023101711190819000_ytad472-B13","doi-asserted-by":"crossref","first-page":"9696","DOI":"10.3390\/ijms22189696","article-title":"Cyclosporine A and tacrolimus induce functional impairment and inflammatory reactions in endothelial progenitor cells","volume":"22","author":"Meyer","year":"2021","journal-title":"Int J Mol Sci"},{"key":"2023101711190819000_ytad472-B14","first-page":"1906","article-title":"Accelerated atherosclerosis in hyperlipidemic C57BL\/6 mice treated with cyclosporin A","volume":"142","author":"Emeson","year":"1993","journal-title":"Am J Pathol"},{"key":"2023101711190819000_ytad472-B15","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.atherosclerosis.2022.01.020","article-title":"A prospective natural history study of coronary atherosclerosis following liver transplantation","volume":"344","author":"Koshy","year":"2022","journal-title":"Atherosclerosis"},{"key":"2023101711190819000_ytad472-B16","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1002\/lt.24100","article-title":"Evolution of serum atherogenic risk in liver transplant recipients: role of lipoproteins and metabolic and inflammatory markers","volume":"21","author":"Chhatrala","year":"2015","journal-title":"Liver Transpl"},{"key":"2023101711190819000_ytad472-B17","doi-asserted-by":"crossref","first-page":"3650","DOI":"10.1016\/j.transproceed.2018.04.030","article-title":"Evolution of biomarkers of atherogenic risk in liver transplantation recipients","volume":"50","author":"Linhares","year":"2018","journal-title":"Transplant Proc"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytad472\/51792297\/ytad472.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/7\/10\/ytad472\/52187342\/ytad472.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/7\/10\/ytad472\/52187342\/ytad472.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,17]],"date-time":"2023-10-17T12:29:37Z","timestamp":1697545777000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytad472\/7285787"}},"subtitle":[],"editor":[{"given":"Vincenzo","family":"Nuzzi","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Waqas","family":"Akhtar","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Tamas","family":"Alexy","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Giulia Elena","family":"Mandoli","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Franca","family":"Morselli","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2023,9,28]]},"references-count":17,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2023,10,5]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytad472","relation":{},"ISSN":["2514-2119"],"issn-type":[{"type":"electronic","value":"2514-2119"}],"subject":[],"published-other":{"date-parts":[[2023,10]]},"published":{"date-parts":[[2023,9,28]]},"article-number":"ytad472"}}