Long-term results of combined kidney and liver transplantation in patients with nephropaty associated with liver disease

Simultaneous Liver-Kidney Transplantation for Adult Recipients With Irreversible End-Stage Renal Disease

“…21 In our experience, of 820 liver transplantations performed between May 1986 and December 2001, CLKT was only done in 16 (approximately 2%), representing a very small proportion, in accordance with data from other series. [22][23][24][25][26][27][28][29][30][31][32] All live patients at the end of this study (62.5%) had functional grafts, and the only functional loss was that related to patient death: actuarial survival was comparable to that obtained in patients receiving only liver transplants (controls) during the same period ( Figure 2). Only 1 patient had cellular rejection that responded well to steroid treatment.…”

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

“…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.…”

“…Early acute kidney rejection rates in combined transplantation are on average less than 10% (Table 10). 12,42,43,[46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61]65,80 This is compared with rejection rates of 30% to 50% reported in the literature for temporally matched kidney-only transplant recipients. 65 Thus, even with less HLA matching and a positive cross-match, renal rejection rates appear to be lower when a liver allograft is placed concurrently ( 3).…”

“…,42,43,[46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61] UNOS data show that liver-kidney transplant recipient survival is determined by the liver disease; renal allograft survival is determined by the reason for renal failure. For instance, 5-year patient survival for patients who underwent LKT for benign hepatic neoplasm is 75.2%; for metabolic diseases, 76%; for noncholestatic cirrhosis, 57%; and for other liver diseases, 73.2% 6.…”