Combined Liver and Heart Transplantation for End-Stage Iron-Induced Organ Failure in an Adult with Homozygous Beta-Thalassemia

doi:10.1056/NEJM199404213301605

Volume 330:1125-1128		April 21, 1994		Number 16

Combined Liver and Heart Transplantation for End-Stage Iron-Induced Organ Failure in an Adult with Homozygous Beta-Thalassemia

Nancy F. Olivieri, Peter P. Liu, Graham D. Sher, Paul A. Daly, Paul D. Greig, Patricia J. McCusker, Anne F. Collins, William H. Francombe, Douglas M. Templeton, and Jagdish Butany

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Most patients with homozygous ${beta}$ -thalassemia require red-celltransfusions to survive beyond the first decade of life. Althoughthis intervention clearly prolongs survival,¹ it also resultsin the accumulation of iron in tissue, which is itself fatalwithout iron-chelating therapy². Before the introduction ofdeferoxamine, iron-induced cardiac dysfunction was a predictableoutcome in thalassemia,³ and it is still the leading cause ofdeath, followed in incidence by hepatic disease¹. Despite thesuccesses with deferoxamine,⁴^,⁵^,⁶^,⁷ many patients still haveserious complications, because of either advanced age at thestart of therapy or erratic compliance⁸^,⁹^,¹⁰^,¹¹^,¹²^,¹³^,¹⁴. Todate, the treatment of . . . [Full Text of this Article]

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From the Hospital for Sick Children (N.F.O., G.D.S., P.J.M., A.F.C.) and the Toronto Hospital (N.F.O., P.P.L., P.A.D., P.D.G., W.H.F., D.M.T., J.B.), Toronto.

Address reprint requests to Dr. Butany at the Department of Pathology, Toronto Hospital, 200 Elizabeth St., Toronto, ON M5G 2C4, Canada.

References

This article has been cited by other articles:

Bernier, P.-L., Grenon, M., Ergina, P., Schricker, T., Chaudhury, P., Metrakos, P., Lachapelle, K. (2007). Combined Simultaneous Heart and Liver Transplantation With Complete Cardiopulmonary Bypass Support. Ann. Thorac. Surg. 83: 1544-1545 [Abstract] [Full Text]
JESSUP, M., MANNO, C. S. (1998). Diagnosis and Management of Iron-induced Heart Disease in Cooley's Anemia. Ann. N. Y. Acad. Sci. 850: 242-250 [Abstract] [Full Text]
Olivieri, N. F., Brittenham, G. M. (1997). Iron-Chelating Therapy and the Treatment of Thalassemia. Blood 89: 739-761 [Full Text]

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