Combined Liver and Kidney Transplantation (Lkt) in Children

Grewal, Hani P.; Brady, Lynda; Cronin, David; Loss, George E.; Siegel, Christopher; Oswald, Katherine; Fisher, Jonathan S.; Bruce, David S.; Aronson, Andrew J.; Woodle, E. Steve; Millis, J. Michael; Thistlethwaite, J. Richard; Newell, Kenneth A.

doi:10.1097/00007890-199810270-00230

Cited by 20 publications

(34 citation statements)

References 13 publications

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“…62 The reason for inferior results in the United States compared with Europe is not known, but perhaps centers on events that increase the risk for the most common causes of death after OLT: infection and multiorgan dysfunction. 21,52,59,[63][64][65] A specific example of poorer patient outcome in the United States compared with Europe is the greater mortality of patients undergoing LKT for primary hyperoxaluria in the United States. European data show a patient survival rate of 79% at 5 years compared with a 56% survival rate at 6 years in the United States.…”

Section: Patient and Graft Outcomes In Combined Lktmentioning

confidence: 99%

Identification of patients best suited for combined liver[ndash ]kidney transplantation: Part II

Davis

Gonwa

Wilkinson

2002

Liver Transplantation

116

105

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Liver-kidney transplantation (LKT) should be reserved for those recipients with primary disease affecting both organs. However, increasing transplant list waiting times have increased the development and duration of acute renal failure before liver transplantation. Furthermore, the need for posttransplant calcineurin inhibitors can render healing from acute renal failure difficult. Because of the increasing requests for and controversy over the topic of a kidney with a liver transplant (OLT) when complete failure of the kidney is not known, the following article will review the impact of renal failure on liver transplant outcome, treatment of peri-OLT renal failure, rejection rates after LKT, survival after LKT, and information on renal histology and progression of disease into the beginnings of an algorithm for making a decision about combined LKT. (Liver Transpl 2002;8:193-211.)

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Section: Patient and Graft Outcomes In Combined Lktmentioning

confidence: 99%

Identification of patients best suited for combined liver[ndash ]kidney transplantation: Part II

Davis

Gonwa

Wilkinson

2002

Liver Transplantation

116

105

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“…Hepatosplenomegaly and portal hypertension make porto-systemic shunt necessary. None of our patients suffered that condition (except in association with polycystic renal disease) but, in those cases were shunt procedures fail, it has been reported that CLKT may have good results [10].…”

Section: Discussionmentioning

confidence: 72%

Renal Outcome after Combined Liver-kidney Transplantation in Children

Urrutia¹

2013

J Transplant Technol Res

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“…When reviewing single-centre experiences, the results appear even more promising; however, the small numbers reported in these studies should caution their interpretation. Grewal et al [20] reported a 42% acute renal allograft rejection rate but only 2/5 cases were proven by biopsy. Rogers et al [21] showed a 25% acute renal allograft rejection rate v. a 86% rejection rate in the kidney after liver transplant cohort.…”

Section: Discussionmentioning

confidence: 99%

Combined paediatric liver-kidney transplantation: Analysis of our experience and literature review

et al. 2013

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Background. Renal insufficiency is increasingly common in end-stage liver disease and allocation of livers to this category of patient has escalated. The frequency of combined liver-kidney transplantation (CLKT) has consequently increased. Indications for CLKT in children differ from those for adults and typically include rare congenital conditions; subsequently limited numbers of this procedure have been performed in paediatric patients worldwide. Scant literature exists on the subject. Methods. Subsequent to institutional approval, a retrospective chart analysis of all paediatric CLKTs performed at the Transplant Unit, Wits Donald Gordon Medical Centre, University of the Witwatersrand, Johannesburg, South Africa between January 2005 and July 2013 was conducted. Results. Defining children as younger than 18 years of age, 43 patients had received a liver transplant since 2005, of whom 8 received a CLKT. Indications included autosomal recessive polycystic kidney disease (n=3), primary hyperoxaluria type 1 (n=4) and heterozygous factor H deficiency with atypical haemolytic uraemic syndrome (n=1). Graft combinations included whole liver and one kidney (n=5), whole liver and two kidneys (n=1) and left lateral liver segment and one kidney (n=2), all from deceased donors. Patient age ranged from 4 to 17 years (median 9) and included 4 females and 4 males. Weight ranged from 13 to 42 kg (median 22.5). We describe one in-hospital mortality. The remaining 7 patients were long-term survivors with a survival range from 6 to 65 months. Conclusions. Although rarely indicated in children, CLKT is an effective treatment option, appropriately utilising a scarce resource and significantly improving quality of life in the recipient.

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Combined Liver and Kidney Transplantation (Lkt) in Children

Cited by 20 publications

References 13 publications

Identification of patients best suited for combined liver[ndash ]kidney transplantation: Part II

Identification of patients best suited for combined liver[ndash ]kidney transplantation: Part II

Renal Outcome after Combined Liver-kidney Transplantation in Children

Combined paediatric liver-kidney transplantation: Analysis of our experience and literature review

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