title: Surgical aspects and outcome of combined liver and kidney transplantation in children.
abstract: In children with renal insufficiency and accompanying or underlying liver disease, combined liver and kidney transplantations (CLKT) are indicated. However, because of the rare indications, the number of paediatric CLKT is low. Our aim was to analyse CLKT in children with special regard to surgical aspects and outcome. All paediatric CLKT performed at our institution between 1998 and 2009 were retrospectively analysed. Between 1998 and 2009, 15 CLKT were performed in 14 paediatric patients (median age 8 years, range 1-16 years). The indications for CLKT were autosomal recessive polycystic kidney disease (n = 7), primary hyperoxaluria type 1 (n = 7) and retransplantation because of primary liver nonfunction (n = 1). In the postoperative course, six patients showed bleeding complications, thereof three patients needed operative revision for intra-abdominal bleeding. Eight of 15 patients (53%) needed dialysis. The 1- and 5-year patient survival was 100%; and 1- and 5-year graft survival was 80% for the liver and 93% for the kidney allograft. A number of different complications, especially secondary haemorrhage have to be anticipated after CLKT, requiring a timely and interdisciplinary treatment approach. With this management, our patients showed an excellent graft and patient survival.
authors: Department of Hepatobiliary Surgery and Visceral Transplantation, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany. utaherden@gmail.com
authors: Uta
authors: U
authors: Herden
authors: Markus
authors: M
authors: Kemper
authors: Rainer
authors: R
authors: Ganschow
authors: Ilka
authors: I
authors: Klaassen
authors: Enke
authors: E
authors: Grabhorn
authors: Florian
authors: F
authors: Brinkert
authors: Bjoern
authors: B
authors: Nashan
authors: Lutz
authors: L
authors: Fischer