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Combined heart–liver transplantation in a case of haemochromatosis
  1. Andrew D Shubin,
  2. Lucia De Gregorio,
  3. Christine Hwang and
  4. Malcolm MacConmara
  1. Department of Surgery, Division of Surgical Transplantation, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
  1. Correspondence to Professor Malcolm MacConmara; Malcolm.MacConmara{at}


Hereditary haemochromatosis results in multiorgan dysfunction secondary to iron overload. Haemojuvelin (HJV)-associated haemochromatosis, is a rapidly progressing form of haemochromatosis caused by mutation in the HJV that frequently results in heart and liver failure. Herein, we describe the successful treatment of a 39-year-old woman with decompensated heart failure and liver cirrhosis requiring extracorporeal membrane oxygenation who was successfully treated with combined heart–liver transplantation. Following her life-saving multiorgan transplantation, she was also noted to have rapid correction of her serum ferritin to normal levels. She remains healthy with excellent allograft function and normal iron and ferratin levels 4 years after the procedure. To our knowledge, this case is the first demonstration that combined heart–liver transplantation is a feasible option for patients with heart and liver failure secondary to HJV-associated haemochromatosis and indeed offers a long-standing corrective solution to treat this condition and restore physiologically normal iron metabolism.

  • transplantation
  • heart failure
  • liver disease
  • genetics
  • cardiothoracic surgery

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  • Contributors ADS prepared the figures and manuscript for publication, LDG supervision writing of the manuscript, CH was cosurgeon in the case and assisted with collection of the clinical data and images, MM was cosurgeon for the liver transplant in this case, provided oversight of the manuscript and completed critical reading and revision of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.