Combined lung and liver transplantation-University Hospital Reina Sofia experience: two case reports.
OBJECTIVE
To analyze the results of combined lung and liver transplantation.


METHODS
We performed two combined lung and liver transplantations for patients with cystic fibrosis with chronic respiratory failure accompanied by advanced liver disease. In each case, all thoracic and abdominal organs were obtained from a single donor by means of standard harvest techniques. In the recipient, a two-stage procedure was adopted with completion of the bilateral lung transplantation before the liver operation. Immunosuppression consisted of three-drug therapy used for isolated lung transplantation.


RESULTS
The patients were both boys of 13 and 15 years old. Episodes of acute pulmonary rejection were successfully treated with intravenous steroids. Neither lung disorder was associated with a liver rejection episode. Airway complications that occurred in both cases were managed endoscopically.


CONCLUSIONS
Combined transplantation of lung and liver is a feasible and therapeutically effective procedure for patients with cystic fibrosis complicated by advanced liver disease. Herein we have described our experience in two of the only three cases of combined liver and lung transplantation performed in Spain to date. Patient and graft survivals were comparable to isolated liver or isolated bilateral lung transplantations.
Moreno Casado
P
P
Thoracic Surgery and Lung Transplantation Unit, University Hospital Reina Sofía, Córdoba, Spain. pmoreno@alumni.unav.es
Alvarez Kindelán
A
A
Algar Algar
F J
FJ
Espinosa Jiménez
D
D
Cano García
J R
JR
Cerezo Madueño
F
F
Baamonde Laborda
C
C
López Cillero
P
P
Salvatierra Velázquez
A
A
D000293:Adolescent; D003550:Cystic Fibrosis / Q000150:complications / Q000601:surgery*; D007839:Functional Laterality; D006785:Hospitals, University; D006801:Humans; D008107:Liver Diseases / Q000150:complications / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods*; D016040:Lung Transplantation / Q000379:methods*; D008297:Male; D013030:Spain; D014184:Transplantation, Homologous; D016896:Treatment Outcome