Successful long-term outcome of pediatric liver-kidney transplantation: a single-center study.
Pediatr Nephrol
; 33(2): 351-358, 2018 02.
Article
de En
| MEDLINE
| ID: mdl-28842757
ABSTRACT
INTRODUCTION:
Liver-kidney transplantation is a rare procedure in children, with just ten to 30 cases performed annually worldwide. The main indications are autosomal recessive polycystic liver-kidney disease and primary hyperoxaluria. This study aimed to report outcomes of liver-kidney transplantation in a cohort of pediatric patients.METHODS:
We retrospectively analyzed all pediatric liver-kidney transplantations performed in our center between September 2000 and August 2015. Patient data were obtained by reviewing inpatient and outpatient medical records and our transplant database.RESULTS:
A total of 14 liver-kidney transplants were performed during the study period, with a median patient age and weight at transplant of 144.4 months (131.0-147.7) and 27.3 kg (12.0-45.1), respectively. The indications for liver-kidney transplants were autosomal recessive polycystic liver-kidney disease (8/14), primary hyperoxaluria -1 (5/14), and idiopathic portal hypertension with end-stage renal disease (1/14). Median time on waiting list was 8.5 months (5.7-17.3). All but two liver-kidney transplants were performed simultaneously. Patients with primary hyperoxaluria-1 tended to present a delayed recovery of renal function compared with patients transplanted for other indications (62.5 vs 6.5 days, respectively, P 0.076). Patients with liver-kidney transplants tended to present a lower risk of acute kidney rejection than patients transplanted with an isolated kidney transplant (7.2% vs 32.7%, respectively; P < 0.07). Patient and graft survival at 1, 3, and 5 years were 100%, 91.7%, 91.7%, and 91.7%, 83.3%, 83.3%, respectively. No other grafts were lost.CONCLUSION:
Long-term results of liver-kidney transplants in children are encouraging, being comparable with those obtained in isolated liver transplantation.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Transplantation rénale
/
Transplantation hépatique
Type d'étude:
Observational_studies
/
Risk_factors_studies
Limites:
Adolescent
/
Child
/
Female
/
Humans
/
Male
Langue:
En
Journal:
Pediatr Nephrol
Sujet du journal:
NEFROLOGIA
/
PEDIATRIA
Année:
2018
Type de document:
Article
Pays d'affiliation:
Espagne