title: Combined liver and kidney transplantation in children.
abstract: Simultaneous combined liver-kidney transplantation (CLKT) is a rare operation in pediatric patients so that annually only 10-30 operations are performed worldwide. The main indications for CLKT are primary hyperoxaluria type 1 and autosomal recessive polycystic kidney disease. In addition, CLKT is indicated in individual patients with metabolic or cirrhotic liver diseases and end-stage kidney disease. The surgery and immediate post-operative management of CLKT remain challenging in infants and small children. The patients should be operated on before they become severely ill or develop major systemic manifestations of their metabolic disorder. The liver allograft is immunologically protective of the kidney graft in simultaneous CLKT, often resulting in well-preserved kidney function. The long-term outcome after CLKT is nowadays comparable to that of isolated liver and kidney transplantations.
authors: Department of Pediatric Nephrology and Transplantation, Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Stenbackinkatu 11, 00290, Helsinki, Finland, Hannu.Jalanko@hus.fi.
authors: Hannu
authors: H
authors: Jalanko
authors: Mikko
authors: M
authors: Pakarinen
mesh_terms: D002648:Child; D006801:Humans; D006960:Hyperoxaluria, Primary / Q000601:surgery; D016030:Kidney Transplantation / Q000379:methods*; D016031:Liver Transplantation / Q000379:methods*; D014181:Transplantation Immunology
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