title: Simultaneous liver and kidney transplantation from different living donors.
abstract: OBJECTIVE
  To present our experience with simultaneous living donor liver and kidney (SLK) transplantation from two different living donors.
  
  
  METHODS
  We performed five SLK transplantations from two different living donors from November 2006 to December 2010. Four patients were males and one, female. Their age range was 47 to 66 years (mean, 55 years). The primary liver diseases included hepatitis B virus (n=2), alcoholic liver cirrhosis (n=2), cryptogenic liver disease (n=1), and hepatitis C virus with hepatocellular carcinoma (n=1). All five patients had chronic renal failure: four were on hemodialysis (H/D) and one on chronic ambulatory peritoneal dialysis for 1 to 20 years. Liver implantation was performed first, followed by kidney transplantation. The liver and kidney teams worked closely to shorten the ischemia time.
  
  
  RESULTS
  All surgical procedures were performed uneventfully and all recipients and donors survived the operations. Good liver graft function was noted in all five patients. The patient with both anti-T- and anti-B-cell positive crossmatch tests developed hyperacute rejection of the kidney graft requiring its immediate removal. This patient was maintained on regular H/D afterward. The other four patients displayed good renal function. No evidence of severe acute rejection was noted during the follow-up period (range, 9-55 months) among patients treated with tacrolimus-based immunosuppression.
  
  
  CONCLUSIONS
  We suggest that SLK transplantation be performed with organs from two different instead of a single live donor.
authors.affiliation: Organ Transplantation Center, China Medical University Hospital, Taichung, Taiwan; Department of Surgery, China Medical University Hospital, Taichung, Taiwan.
authors.forename: K-S
authors.initials: KS
authors.lastname: Soh
authors.forename: L-B
authors.initials: LB
authors.lastname: Jeng
authors.forename: H-R
authors.initials: HR
authors.lastname: Yang
authors.forename: P-C
authors.initials: PC
authors.lastname: Li
authors.forename: C-C
authors.initials: CC
authors.lastname: Lee
authors.forename: K-S
authors.initials: KS
authors.lastname: Poon
authors.forename: T-H
authors.initials: TH
authors.lastname: Chen
authors.forename: C-C
authors.initials: CC
authors.lastname: Yeh
authors.forename: H-C
authors.initials: HC
authors.lastname: Lai
authors.forename: W-P
authors.initials: WP
authors.lastname: Su
authors.forename: C Y
authors.initials: CY
authors.lastname: Peng
authors.forename: Y-F
authors.initials: YF
authors.lastname: Chen
authors.forename: Y-J
authors.initials: YJ
authors.lastname: Ho
mesh_terms: D000368:Aged; D005260:Female; D006084:Graft Rejection / Q000209:etiology / Q000601:surgery; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000150:complications / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects; D008107:Liver Diseases / Q000150:complications / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D016559:Tacrolimus / Q000627:therapeutic use; D013624:Taiwan; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus