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Background  Heart retransplant ( HRT ) recipients represent a growing number of transplant patients. The impact of concurrent kidney transplants ( KTs ) in this population has not been well studied. We tested the hypothesis that recipients of HRT with concurrent KT ( HRT ‐ KT ) would have worse survival than recipients of  HRT  alone.    Methods and Results  A retrospective analysis of the United Network of Organ Sharing database was performed for all patients undergoing  HRT  from 1987 to 2011. There were 1660  HRT  patients, of which 116 (7%) received concurrent  KT . Those who received  HRT ‐ KT  had older age, longer wait‐list time, worse kidney function, and more known diabetes. Survival among recipients of  HRT ‐ KT  was significantly better than that of recipients of  HRT  alone ( P =0.005). A subgroup of 323  HRT  patients with severe kidney dysfunction (estimated glomerular filtration rate <30 mL/min per 1.73 m 2  or on dialysis) was studied in more detail, and 76 (24%) received concurrent  KT . Those on dialysis at the time of  HRT  had better survival with versus without concurrent  KT  ( P <0.0001). On multivariable analysis, concurrent  KT  was independently associated with better outcomes for all patients with  HRT  and for the subgroup of patients with severe kidney dysfunction.    Conclusions  Recipients of  HRT ‐ KT  have better survival than recipients of  HRT  alone. Further research is needed to determine which  HRT  patients may benefit the most from concurrent  KT .

Heart Retransplant Recipients Have Better Survival With Concurrent Kidney Transplant Than With Heart Retransplant Alone