title: Longterm renal allograft survival after sequential liver-kidney transplantation from a single living donor.
abstract: Combined liver-kidney transplantation (CLKT) is well established as a definitive therapy with the potential to provide complete recovery for certain liver-kidney diseases, although the results might be contingent on the cause of transplantation. The purposes of the present study were to review the longterm outcome of renal allografts in CLKT patients from single living donors and to investigate the beneficial factors, compared with solitary renal transplantation. Thirteen patients underwent sequential liver transplantation (LT) and kidney transplantation (KT) from single living donors. The indications for KT were oxaluria (n = 7), autosomal recessive polycystic disease (n = 3), and others (n = 3). The same immunosuppressive regimen used after LT was also used after KT. KT was performed between 1.7 and 47.0 months after the LT. The overall patient survival rate was 92.3% at 10 years. In 12 of the 13 surviving patients, the renal allografts were found to be functioning in 11 patients after a mean follow-up period of 103.6 months. The death-censored renal allograft survival rate at 10 years was 100%, which was better than that of KT alone (84.9%) in Japan. Immunological protection conferred by the preceding liver allograft may have contributed to the longterm outcomes of the renal allografts. In addition, the donation of double organs from a single living and related donor may have a favorable impact on the graft survival rate. In the future, investigations of factors affecting the longterm outcome of renal allografts, including details of the involvement of de novo donor-specific antibody, will be needed. Liver Transplantation 23 315-323 2017 AASLD.
authors.affiliation: Department of Surgery, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Kumiko
authors.initials: K
authors.lastname: Kitajima
authors.affiliation: Department of Surgery, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ogawa
authors.affiliation: Department of Surgery, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Miki
authors.affiliation: Department of Surgery, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Kotaro
authors.initials: K
authors.lastname: Kai
authors.affiliation: Department of Surgery, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Akihito
authors.initials: A
authors.lastname: Sannomiya
authors.affiliation: Department of Surgery, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Iwadoh
authors.affiliation: Department of Surgery, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Murakami
authors.affiliation: Department of Surgery, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Koyama
authors.affiliation: Department of Surgery, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Nakajima
authors.affiliation: Department of Surgery, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Shohei
authors.initials: S
authors.lastname: Fuchinoue
mesh_terms: D000293:Adolescent; D000328:Adult; D064591:Allografts / Q000276:immunology / Q000473:pathology; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D058625:End Stage Liver Disease / Q000209:etiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology* / Q000276:immunology / Q000517:prevention & control; D006085:Graft Survival; D006801:Humans; D006959:Hyperoxaluria / Q000150:complications / Q000601:surgery; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D007564:Japan / Q000453:epidemiology; D007668:Kidney / Q000276:immunology / Q000473:pathology; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000379:methods; D008099:Liver / Q000276:immunology / Q000473:pathology; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods; D019520:Living Donors; D008297:Male; D017044:Polycystic Kidney, Autosomal Recessive / Q000150:complications / Q000601:surgery; D015996:Survival Rate; D020858:Tissue and Organ Harvesting / Q000379:methods; D014184:Transplantation, Homologous / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents