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

Abstract

Most patients with homozygous β-thalassemia require red-cell transfusions to survive beyond the first decade of life. Although this intervention clearly prolongs survival,1 it also results in the accumulation of iron in tissue, which is itself fatal without iron-chelating therapy2. Before the introduction of deferoxamine, iron-induced cardiac dysfunction was a predictable outcome in thalassemia,3 and it is still the leading cause of death, followed in incidence by hepatic disease1. Despite the successes with deferoxamine,4–7 many patients still have serious complications, because of either advanced age at the start of therapy or erratic compliance8–14. To date, the . . .