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

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.