Initial experience of 6 cases of combined liver-kidney transplantation at a single center / 中华器官移植杂志

ABSTRACT

Objective To investigate the experiences of combined liver-kidney transplantation (CLKTx).Methods Six patients underwent CLKTx in our center. The primary diseases included chronic glomerulonephritis and post-hepatitis B cirrhosis in 4 patients, hepatitis B virus associated nephritis and primary hepatocellular carcinoma in 1 patient, and polycystic kidney and polycystic liver in 1 patient. Cyclosporine A (or tarcrolimus), mycophenolate mofetil and methylprednisolone were applied to prevent rejection. Four cases of post-hepatitis B cirrhosis received lamivudine. And hepatitis B immunogloblin was given to 4 patients for a short term.Results All 6 liver grafts had good primary function. Five renal grafts had good primary function within one week post-transplantation. One patient with delayed kidney graft function needed supportive hemodialysis. The serum creatinine was declined to normal level 52 days post-operation. Pleural effusion occurred in all 6 patients among which 2 patients needed surgical drainage. Two patients had to be treated for bacterial pneumonia and pneumocystis carinii pneumonia respectively. Three patients needed lipid-lowering therapy at early time post-operation. At the last follow-up, all 6 patients were alive with normal renal graft function and liver graft function. The panel reactive antibody (PRA) of one patient was 23 % before transplantation, and remained at about 8 % post-transplantation. The serum HBsAg and HBV DNA of all 4 post- hepatitis B cirrhosis patients became negative post-transplantation.Conclusion CLTx is a safe procedure for combined hepatic and renal end-stage disease with excellent short-term results.