Combined liver-kidney transplantation: long-term follow up in 18 patients.
Since August 1992, 18 patients underwent combined liver and kidney transplantation. Eight patients had lymphocytotoxic antibodies pretransplant and 5 of these patients (27.7%) had a positive crossmatch. Fifteen patients received cyclosporine-based immunosuppression and 3 patients were treated with a tacrolimus-based immunosuppressive protocol. One patient died in the postoperative course due to intractable bleeding episodes after 96 days and one kidney graft was lost due to technical complications. The 1 year survival rate of patients with combined transplantation was 95% vs 87% in patients with liver transplantation alone. None of the patients with a positive crossmatch experienced a hyperacute rejection of the kidney. The long-term patient and graft survival was not impaired in patients with a positive crossmatch. These results suggest that combined liver-kidney transplantation is a safe treatment for end-stage liver and renal disease. A positive crossmatch or positive lymphocytotoxic antibodies are not contraindications for a combined transplantation.
Department of Surgery, Virchow Clinic, Humboldt University Berlin, Germany.
M
M
Lang
A
A
Kahl
W
W
Bechstein
U
U
Neumann
M
M
Knoop
U
U
Frei
P
P
Neuhaus
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects / Q000401:mortality / Q000502:physiology; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality / Q000502:physiology; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D013997:Time Factors; D014181:Transplantation Immunology