# Combined Heart-Liver Transplantation: A First Successful Case in Chile

## TL;DR

This paper reports the first successful combined heart and liver transplant in Chile, showing it is feasible with proper care.

## Contribution

The novelty is the successful execution of CHLT in Chile, demonstrating its viability in a new context.

## Key findings

- The patient fully recovered after a complex combined heart-liver transplant.
- More than one year post-transplant, the patient remains healthy with excellent graft function.
- Multidisciplinary coordination is crucial for successful outcomes in multi-organ transplants.

## Abstract

Combined heart-liver transplantation (CHLT) is a rare and highly complex procedure reserved for patients with end-stage failure of both organs. We report the first successful CHLT performed in Chile, involving a 55-year-old man with severe dilated cardiomyopathy and chronic liver disease who underwent sequential bicaval heart transplantation followed by piggyback liver transplantation. The postoperative course was complicated by acute neurological deterioration due to an acute subdural hematoma with tentorial extension requiring decompressive craniectomy, after which the patient recovered fully. More than one year after transplantation, he remains in excellent health, physically active, and fully reintegrated into work, with excellent function of both grafts. This case highlights the feasibility of CHLT in Chile and underscores the importance of multidisciplinary evaluation and coordinated perioperative management in optimizing outcomes for patients with advanced multi-organ failure.