Longterm renal allograft survival after sequential liver‐kidney transplantation from a single living donor

Kitajima, Kumiko; Ogawa, Yuichi; Miki, Katsuyuki; Kai, Kotaro; Sannomiya, Akihito; Iwadoh, Kazuhiro; Murakami, Toru; Koyama, Ichiro; Nakajima, Ichiro; Fuchinoue, Shohei

doi:10.1002/lt.24676

Cited by 32 publications

(42 citation statements)

References 27 publications

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“…The published graft survival rates from the region include 78.0% (5‐year follow‐up) reported in a study from Oman, 88% (5‐year follow‐up) from Jordan, and 89.2% (10‐year follow‐up) from Iran . The five‐year patient survival rates observed in our study were 96.7% which is promising compared to the 10‐year follow‐up published reports of 89.2% (10‐year) from India and Iran, 92.3% (10‐year) from single‐center study in Japan, and 92.0% (10‐year) from a single‐center study in France . Overall patient survival among pediatric kidney transplant recipients from LRD has been reported above 90% at 10 years post‐transplant .…”

Section: Discussionsupporting

confidence: 60%

Good outcome of the single‐center pediatric kidney transplant program in Abu Dhabi

Kumar

Al-Ismaili

Ilyas

et al. 2019

Pediatric Transplantation

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Renal transplantation is the treatment of choice for ESRD in children. It is associated with better quality of life, growth of children, and improved long‐term survival. The aim of the study was to evaluate the outcomes of pediatric renal transplantation at a tertiary care center in UAE. A retrospective chart review was undertaken for all the pediatric renal transplants performed at Sheikh Khalifa Medical City, Abu Dhabi, UAE, over the past 9 years. The study evaluated the demographic data, outcomes, and complications of pediatric renal transplantation. The post‐transplantation outcomes including surgical complications, documented infections, graft rejection, graft and patient survival, effect on growth, and eGFR were reviewed. Between 2010 and 2018, 30 pediatric patients underwent renal transplantation. The follow‐up period ranged from 1 to 9 years with a mean of 3.3 years. The mean age of the patients at the time of transplant was 9.8 years, and 56.7% were males. Prior to the transplantation, the majority of the recipients were on peritoneal dialysis (70.0%). Main source of renal donation at our center was from LRD, chiefly from parents. Patient survival at 1 and 5 years was 100% and 96.7%, respectively. Graft survival at 1 and 5 years was 96.7% and 83.3%, respectively. During the 9‐year follow‐up period, 5 (16.7%) recipients experienced rejection episode. This study demonstrates that during 5‐year period, pediatric kidney transplantation program has achieved optimal patient (96.7%) and graft (83.3%) survival rates and is comparable to well‐established centers.

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Section: Discussionsupporting

confidence: 60%

Good outcome of the single‐center pediatric kidney transplant program in Abu Dhabi

Kumar

Al-Ismaili

Ilyas

et al. 2019

Pediatric Transplantation

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“…For SLKT cases, most often one of the organs is procured from a living donor and the other from a deceased donor . Reports about CLKT and SLKT from a single living donor are limited from countries where a shortage of deceased donors remains a problem . In this single‐center series, it is illustrated that CLKT and SLKT are feasible and safe from a single living donor, even in pediatric patients.…”

Section: Discussionmentioning

confidence: 87%

“…Even though most publications about PH1 patients who have undergone transplantation have reported on deceased donors, studies reporting on living donors with good outcomes have increased in recent years . Most of the CLKT reports have been on cases from single deceased donors.…”

Section: Discussionmentioning

confidence: 99%

“…Most studies report on CLKT and SLKT in patients with PH1 from deceased donors. There are a few reports in which both organs were taken from a single living donor from countries where a shortage of organ donation remains a problem, as in Turkey . The aim of this report was to describe our experience with CLKT and SLKT from single living donors in patients with PH1.…”

Section: Introductionmentioning

confidence: 99%

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The experience of combined and sequential liver and kidney transplantation from a single living donor in patients with primary hyperoxaluria type 1

Ozer

Aktaş

Bulum

et al. 2019

Pediatric Transplantation

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LKT is the only effective treatment for PH1 because it replaces both the source (liver) and the target (kidney) of the disease. Most studies report on LKT in patients with PH1 from deceased donors. This study reports on five patients who underwent LKT from a single living donor between April 2017 and March 2018. Combined LKT was performed for 1 patient and sequential LKT for the remainder. The median age of the patients at the time of diagnosis and transplantation was 5.5 (0.3‐18) and 10 (6‐21) years, respectively. All patients received left lateral liver segment transplantation, except one patient who received right liver lobe transplantation. No liver graft loss was observed, and liver function tests were stable at the final evaluation of all patients. Renal function tests of the patients were also stable at the final assessment, except for the young adult patient. None of the patients suffered from acute rejection. One patient died at the second month following liver transplantation due to severe pneumonia and sepsis. This study concludes that combined or sequential LKT from a single living donor can be safely performed and provides encouraging results for even the youngest and smallest patients with PH1.

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“…appears to provide immunoprotection compared with single heart 8 or kidney [9][10][11] grafts, suggesting the liver allograft may promote systemic suppression of the antidonor response. appears to provide immunoprotection compared with single heart 8 or kidney [9][10][11] grafts, suggesting the liver allograft may promote systemic suppression of the antidonor response.…”

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confidence: 99%

Deletion of donor-reactive T cell clones after human liver transplant

Savage

Shonts

Lau

et al. 2020

American Journal of Transplantation

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| INTRODUC TI ONLiver transplantation has been associated with relatively high rates of successful immunosuppression withdrawal in recipients who have been free of rejection for years. 1,2 Despite T cell infiltration associated with hepatitis C virus (HCV) and recurrent HCV posttransplant, 3 a subset of HCV-infected liver transplant recipients have successfully achieved tolerance. 4Spontaneous liver allograft tolerance occurs in rodent models across major histocompatibility complex barriers 5 and is associated with donor-specific tolerance to subsequent skin 6 or cardiac allografts. 7 Moreover, cotransplantation of liver allografts in humans We recently developed a high throughput T cell receptor β chain (TCRβ) sequencing-based approach to identifying and tracking donor-reactive T cells. To address the role of clonal deletion in liver allograft tolerance, we applied this method in samples from a recent randomized study, ITN030ST, in which immunosuppression withdrawal was attempted within 2 years of liver transplantation. We identified donor-reactive T cell clones via TCRβ sequencing following a pre-transplant mixed lymphocyte reaction and tracked these clones in the circulation following transplantation in 3 tolerant and 5 non-tolerant subjects. All subjects showed a downward trend and significant reductions in donor-reactive TCRβ sequences were detected post-transplant in 6 of 8 subjects, including 2 tolerant and 4 non-tolerant recipients. Reductions in donor-reactive TCRβ sequences were greater than those of all other TCRβ sequences, including 3rd party-reactive sequences, in all 8 subjects, demonstrating an impact of the liver allograft after accounting for repertoire turnover. Although limited by patient number and heterogeneity, our results suggest that partial deletion of donor-reactive T cell clones may be a consequence of liver transplantation and does not correlate with success or failure of early immunosuppression withdrawal. These observations underscore the organ-and/or protocol-specific nature of tolerance mechanisms in humans. K E Y W O R D Sbasic (laboratory) research/science, immunobiology, liver transplantation/hepatology, monitoring: immune, T cell biology, tolerance

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Longterm renal allograft survival after sequential liver‐kidney transplantation from a single living donor

Cited by 32 publications

References 27 publications

Good outcome of the single‐center pediatric kidney transplant program in Abu Dhabi

Good outcome of the single‐center pediatric kidney transplant program in Abu Dhabi

The experience of combined and sequential liver and kidney transplantation from a single living donor in patients with primary hyperoxaluria type 1

Deletion of donor-reactive T cell clones after human liver transplant

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