Kidney transplantation combined with other organs in Bologna: an update.
BACKGROUND
We retrospectively reviewed our experience in combined liver-kidney (L-KT) and heart-kidney (H-KT) transplantations.


METHODS
Between January 1997 and April 2007, we performed 25 L-KT and 5 H-KT. Patient mean age was 51+/-8 years in L-KT and 43+/-11 years in H-KT. The main cause of liver failure was chronic viral hepatitis (14 cases). Etiology of heart failure was dilated cardiomyopathy and hypertrophic cardiomyopathy (4 and 1 patients, respectively). The main causes of renal failure in L-KT were chronic glomerulonephritis (n=8) and polycystic disease (n=7). Etiology of renal failure in H-KT was interstitial nephropathy (n=2), vascular nephropathy (n=2), and chronic glomerulonephritis (n=1).


RESULTS
Mean follow-up was 32+/-26 months in L-KT and 24+/-17 months in H-KT. Immunosuppression was cyclosporine-based (n=4) or tacrolimus-based (n=21) in L-KT and cyclosporine-based in H-KT. Acute rejection rate was 8% for both liver and kidney in L-KT; 80% (mild) for heart and 40% for kidney in H-KT. In the L-KT group, there was no primary graft nonfunction (PGNF). Two patients experienced liver delayed graft function (DGF); 1 patient required postoperative dialysis. One-year graft and patient survivals were both 84% and overall graft and patient survival was 76%. In the H-KT group, 3 patients needed postoperative dialysis and 1 required a cardiac assistance device for 48 hours; overall graft and patient survival was 100% with good cardiac and renal functions.


CONCLUSIONS
Our experience confirmed that H-KT and L-KT are safe procedures, offering good long-term results.
Bertelli
R
R
Department of Surgery, Intensive Care and Transplantation, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. riccardobertelli@hotmail.com
Nardo
B
B
Cavallari
G
G
Ercolani
G
G
Lauro
A
A
Neri
F
F
Tsivian
M
M
Grazi
G L
GL
Mikus
P M
PM
Pilato
E
E
Mikus
E
E
Arpesella
G
G
Pinna
A D
AD
Stefoni
S
S
Fuga
G
G
Faenza
A
A
D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000150:complications*; D016027:Heart Transplantation / Q000706:statistics & numerical data*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007558:Italy; D007674:Kidney Diseases / Q000150:complications / Q000601:surgery*; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D008107:Liver Diseases / Q000150:complications / Q000601:surgery*; D016031:Liver Transplantation / Q000706:statistics & numerical data*; D018579:Patient Selection; D012189:Retrospective Studies; D016896:Treatment Outcome
D007166:Immunosuppressive Agents