Combined liver and kidney transplantation in a multicenter transplantation program in Chile.
BACKGROUND
Combined liver and kidney transplantation (CLKT) is an exceptional therapeutic procedure limited to a few diseases with advanced compromise of these organs. Hyperoxaluria type I and polycystic disease are the most frequent indications. The aim of this article was to report our indications and results of CLKT in a multicenter transplantation program in Chile.


METHODS
Our Excel database was reviewed to select patients who were treated with CLKT between 1993 and July 2004.


RESULTS
Among 242 liver transplantations (LT) and 48 kidney transplantations (KT), 7 were CLKT, representing 2.8% of LT and 14.5% of KT. Four patients were women and 3 were male of average age 46.8 years. One patient was a child. Most frequent indications were chronic renal failure associated with terminal liver disease and polycystic disease. One patient needed liver retransplantation due to hepatic vein thrombosis. One patient had a biliary fistula and another had a urinary fistula, treated conservatively. Acute liver rejection took place in 3 cases, 1 of which required antibodies. Two patients died, 1 due to aspergillosis and the other due to vascular complications in the transplanted liver. Actuarial survival rates were 71.4% at 1 and 5 years. Chronic renal failure is not a contraindication to LT.


CONCLUSIONS
CLKT is an acceptable option for these patients.
Buckel
E
E
Programa Trasplante Hepático Clinica Las Condes, Hospital Luis Calvo Mackenna, Lo Fontecilla 441, Las Condes, Santiago, Chile. koka.g@vtr.net
Morales
J
J
Brahm
J
J
Fierro
M F A
MF
Silva
G
G
Segovia
R
R
Godoy
J
J
González
G
G
Smok
G
G
Herzog
C
C
Santander
M T
MT
Calabrán
L
L
Uribe
M
M
D002648:Child; D002677:Chile; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000401:mortality / Q000706:statistics & numerical data*; D016031:Liver Transplantation / Q000401:mortality / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome