Simultaneous liver-kidney transplantation: A single-center experience in Korea

Abstract

Backgrounds/Aims: Simultaneous liver and kidney transplantation (SLKT) has been established as the treatment of choice for patients with concurrent end-stage liver and end-stage kidney diseases. The objective of this study was to analyze the nationwide incidence of SLKT in Korea and the outcomes of SLKT in a high-volume transplant center. Methods: Databases of the Korean Network for Organ Sharing (KONOS) and Asan Medical Center from 2000 to 2019 were retrospectively reviewed to determine the incidence of SLKT. Results: During 20 years from 2000 to 2019, deceased donor SLKT was performed for 38 cases in the KONOS database. The proportion of deceased donor SLKT was 0.6% (20 of 3333) before adoption of MELD score, which was significantly increased to 1.2% (18 of 1524) after the adoption of MELD score (p=0.034). In our institution, there were 11 cases of SLKT (2 cases with deceased donors and 9 cases with living donors). SLKT accounted for 0.2% (11 of 6468) of total liver transplantation volume. During follow-up, five patients died due to hepatocellular carcinoma recurrence (n=2), infection (n=2), or unknown cause (n=1). The 1-year and 10-year overall patient survival rates were 90.9% and 81.8%, respectively. Conclusions: Results of this study revealed that the incidence of deceased donor SLKT was very low. An increase of such incidence is not anticipated unless the number of deceased donors is markedly increased. Currently, sequential living donor liver transplantation and kidney transplantation with deceased or living donors are mainstays of transplantation rather than SLKT in our institution.

Dual living donor organ transplants

“…Also in Turkey, in 2001, a 20‐year‐old woman simultaneously donated the left liver lobe (segments 2–4) and the right kidney to her 9‐year‐old brother to treat primary hyperoxaluria type I 13–15 . Between 2000 and 2019, nine simultaneous LD liver‐kidney transplants in adult recipients were performed in South Korea 16 . The first simultaneous LD right lobe liver and kidney transplant (father donating to son) was reported by Marujo et al.…”

“…[13][14][15] Between 2000 and 2019, nine simultaneous LD liver-kidney transplants in adult recipients were performed in South Korea. 16 The first simultaneous LD right lobe liver and kidney transplant (father donating to son) was reported by Marujo et al in Brazil in 1999. 17 Another report from Brazil described a sequential LD kidney and right lobe liver transplant, over a 20-year time interval, between two brothers.…”

Initial Experience of Anesthetic Management in Combined Liver-Kidney Transplantation: A Case Report

“…Since the first reported CLKT by Margreiter et al, in 1984 [2], the number of CLKT cases has increased significantly, with the count in 2019 being triple that of 2001 [3]. In South Korea, only 38 CLKTs were performed from 2000 to 2019 [4]. However, considering the rising incidence of CKD in the South Korean population, an increase in CLKT procedures is expected [5].…”