Long-term Results of Living Donors in Simultaneous Kidney and Liver Transplantations.
BACKGROUND
Because of the shortage of organs available for transplantation, living related sequential transplantation with the use of liver and a kidney from the same donor has emerged as a reasonable therapeutic alternative. However, there is insufficient literature about the complications that living donors experience after simultaneous kidney and liver transplantations.


METHODS
From December 2001 to October 2009, 5 living donors provided simultaneous donation of livers and kidneys and 1 living donor donated first her kidney and then her liver. Demographic data of the donors and information concerning the surgery and postoperative observation were collected prospectively.


RESULTS
All of the donors were female. The median age was 27.5 (range, 19-36) years. Indications requiring the simultaneous transplantation of livers and kidneys were primary hyperoxaluria type 1 (PH1) in 5 potential recipients and cirrhosis due to chronic hepatitis B infection and idiopathic chronic renal insufficiency in 1 potential recipient. Four recipients underwent right hepatectomy (segments 5-8) and right nephrectomy; 1 recipient underwent left hepatectomy (segments 2-4) and right nephrectomy; and 1 recipient underwent left lobectomy (segments 2-3) and right nephrectomy. There were no complications except in 1 donor (postoperative ileus). No donor developed hypertension or microalbuminuria.


CONCLUSIONS
With the right indications, appropriate preoperative evaluation, meticulous surgical technique, proper postoperative care, and long-term close monitoring to minimize morbidity and mortality risks, liver and kidney donation from the same donor can be considered for simultaneous kidney and liver transplantation.
Department of General Surgery, Dokuz Eylul University School of Medicine, Balcova, Izmir, Turkey. Electronic address: tarkan.unek@deu.edu.tr.
T
T
Unek
Department of General Surgery, Dokuz Eylul University School of Medicine, Balcova, Izmir, Turkey.
T
T
Egeli
Department of General Surgery, Dokuz Eylul University School of Medicine, Balcova, Izmir, Turkey.
M
M
Özbilgin
Department of Nephrology, Dokuz Eylul University School of Medicine, Balcova, Izmir, Turkey.
A
A
Çelik
Department of General Surgery, Dokuz Eylul University School of Medicine, Balcova, Izmir, Turkey.
K
K
Atilla
Department of General Surgery, Dokuz Eylul University School of Medicine, Balcova, Izmir, Turkey.
C
C
Ağalar
Department of General Surgery, Dokuz Eylul University School of Medicine, Balcova, Izmir, Turkey.
N Ç
NÇ
Arslan
Department of General Surgery, Dokuz Eylul University School of Medicine, Balcova, Izmir, Turkey.
S
S
Karademir
Department of General Surgery, Dokuz Eylul University School of Medicine, Balcova, Izmir, Turkey.
S
S
Bora
Department of General Surgery, Dokuz Eylul University School of Medicine, Balcova, Izmir, Turkey.
H
H
Gülay
Department of General Surgery, Dokuz Eylul University School of Medicine, Balcova, Izmir, Turkey.
Z S
ZS
Derici
Department of General Surgery, Dokuz Eylul University School of Medicine, Balcova, Izmir, Turkey.
I
I
Astarcıoğlu
D000328:Adult; D005260:Female; D006801:Humans; D006960:Hyperoxaluria, Primary / Q000601:surgery; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation; D008103:Liver Cirrhosis / Q000601:surgery; D016031:Liver Transplantation; D019520:Living Donors; D011183:Postoperative Complications; D055815:Young Adult