Faculty Collaboration Database

Simultaneous combined liver and kidney transplantation: a single center experience. Clin Transplant 2010;24(3):E62-8

Date

07/14/2010

Pubmed ID

20618811

DOI

10.1111/j.1399-0012.2010.01168.x

Scopus ID

2-s2.0-77954164410 (requires institutional sign-in at Scopus site)   25 Citations

Abstract

Renal dysfunction is common in patients awaiting liver transplantation (LT) and affects outcome following LT. Combined liver and kidney transplantation (CLKT) has been proposed as effective treatment for patients with chronic diseases of both organs, some with hepatorenal syndrome and for liver-based metabolic diseases affecting kidney. This study is undertaken to analyze results of CLKT at a single center. Of 2690 LTs performed between 1992 and 2007, there were 39 CLKTs; most common indications were metabolic, cirrhosis and polycystic disease. With follow-up of up to 170 months, 11 died (overall survival 71.8%); one-, five-, and 10-yr patient and liver graft survival is 77%, 73.7%, and 73.7%, respectively, and kidney graft survival is 77%, 70%, and 70%, respectively. Survival among metabolic group (78.6%) appeared to be better than non-metabolic group (68%); however, this difference was not significant (p = 0.39). Fifteen surviving patients (53.6%) have mild/moderate renal impairment (creatinine > or = 125 micromol/L). None has severe renal failure (serum creatinine > or = 250 micromol/L) or end-stage renal disease requiring hemodialysis. CLKT has good results in selected groups of patients. It provides protection to kidney allograft in liver-based metabolic diseases affecting kidney. The rate of acute rejection episodes of kidney is low. Significant proportion develops long-term mild/moderate renal dysfunction. Careful attention to immunosuppression to minimize nephrotoxicity may help.

Author List

Chava SP, Singh B, Stangou A, Battula N, Bowles M, O'Grady J, Rela M, Heaton ND

Author

Narendra Battula MD Associate Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Female
Follow-Up Studies
Graft Rejection
Graft Survival
Humans
Immunosuppressive Agents
Incidence
Kidney Transplantation
Liver Transplantation
Male
Middle Aged
Retrospective Studies
Risk Factors
Survival Rate
Time Factors
Treatment Outcome