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Often, these patients develop human leukocyte antigen antibodies from their previous allografts and are therefore more difficult to re\u2010transplant. We describe the largest case series of a predominantly sensitized pediatric <jats:styled-content style=\"fixed-case\">sHKT<\/jats:styled-content>x with emphasis on medical management and patient outcomes. Demographics, clinical characteristics, antibody, and biopsy data were retrospectively collected from University of California, Los Angeles database and correlated with short\u2010 and long\u2010term patient and allograft outcomes of all <jats:styled-content style=\"fixed-case\">sHKT<\/jats:styled-content>x performed between 2002 and 2015. We identified seven pediatric patients who underwent <jats:styled-content style=\"fixed-case\">sHKT<\/jats:styled-content>x at our center. Mean age at time of <jats:styled-content style=\"fixed-case\">sHKT<\/jats:styled-content>x was 13.7\u00a0years and 85.7% were re\u2010graft patients. 57.1% were sensitized with <jats:styled-content style=\"fixed-case\">cPRA<\/jats:styled-content> &gt;50% and another 57.1% had preformed donor\u2010specific antibody. Five\u2010year renal allograft survival and patient survival was 85.7% for both end\u2010points. The remaining six patients are all alive (mean follow\u2010up 78.5\u00a0months) with good kidney and heart function. <jats:styled-content style=\"fixed-case\">sHKT<\/jats:styled-content>x in a population with increased immunological risk can be associated with good long\u2010term outcomes and offers potential guidance to the pediatric transplant community where data are limited.<\/jats:p>","DOI":"10.1111\/petr.13023","type":"journal-article","created":{"date-parts":[[2017,7,20]],"date-time":"2017-07-20T12:22:43Z","timestamp":1500553363000},"source":"Crossref","is-referenced-by-count":7,"title":["Long\u2010term outcomes of simultaneous heart and kidney transplantation in pediatric recipients"],"prefix":"10.1111","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2020-2729","authenticated-orcid":false,"given":"Patricia L.","family":"Weng","sequence":"first","affiliation":[{"name":"Division of Pediatric Nephrology Mattel Children's Hospital UCLA  Los Angeles CA 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