Combined liver and kidney transplantation in Guangzhou, China.
BACKGROUND
When liver or kidney transplant can respectively cure end-stage liver or kidney disease, neither hepatic graft nor renal transplant alone can be used as a radical therapy for diseases which involve both liver and kidney. Combined liver and kidney transplantation commenced late in China, and the number of transplants has been limited. This study was designed to assess the effects of simultaneous combined liver and kidney transplantation (SLKT) on end-stage liver and kidney diseases.


METHODS
Fifteen patients who had received SLKT from 1996 to 2006 in the First Affiliated Hospital of Sun Yat-Sen University were reviewed. They included 5 patients with polycystic liver and kidney, 5 patients with hepatic cirrhosis and renal failure, and 5 patients with fulminant hepatic failure and hepatorenal syndrome (11 men and 4 women; average age 43.5 years). All patients had combined liver and kidney transplantation.


RESULTS
The 5 patients with polycystic liver and kidney have survived for more than one year after SLKT, and the longest survival has been 5 years. Three of the 5 patients with hepatic cirrhosis and renal failure have survived more than two years; one died perioperatively and the other died from recurrence of hepatitis B 18 months after the operation. Three of the 5 patients with fulminant hepatic failure and hepatorenal syndrome have survived for two years, and 2 died of multiple organ failure during the operation.


CONCLUSIONS
SLKT is an effective therapy for end-stage liver and kidney disease but the indications of SLKT for hepatorenal syndrome should be strict. SLKT may immunologically protect the renal graft.
Zhu
Xiao-Feng
XF
Organ Transplantation Center, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China. zxf111@hotmail.com
He
Xiao-Shun
XS
Chen
Gui-Hua
GH
Chen
Li-Zhong
LZ
Wang
Chang-Xi
CX
Huang
Jie-Fu
JF
D000328:Adult; D005260:Female; D006530:Hepatorenal Syndrome / Q000601:surgery; D006801:Humans; D016030:Kidney Transplantation; D008103:Liver Cirrhosis / Q000601:surgery; D017093:Liver Failure / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D007690:Polycystic Kidney Diseases / Q000601:surgery