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Ann Hepatol. 2013 Mar-Apr;12(2):274-81.

Comparison of results of combined liver-kidney transplantation vs. isolated liver transplantation.

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  • 1Hepatology Unit, Hospital Universitario La Fe, Valencia, Spain. toyagui@hotmail.com

Abstract

INTRODUCTION:

Combined liver-kidney transplantation (LKT) is the best therapeutic option for patients with end-stage liver and kidney disease.

OBJECTIVES:

To analyze baseline characteristics and clinical outcome of LKT compared to isolated liver transplantation (LT).

MATERIAL AND METHODS:

The study included 16 LKT performed between 1998 and 2006 and 32 LT matched by age, sex, date and indication for transplantation. Demographic, pretransplant, post-transplant and survival variables were analyzed.

RESULTS:

As planned by the study design, mean age, distribution by sex and indication for LT were similar between groups. The most common indication for LT was HCV- and/or alcohol-induced cirrhosis. The most common indication for KT was renal failure, in most cases secondary to glomerulonephritis. Twelve patients (69%) were on dialysis before LKT. Hepatocellular carcinoma and diabetes mellitus pre-transplantation were similar between groups. However pretransplant arterial hypertension (AHT) was higher in LKT than LT (50% vs. 19%; p = 0.02). In the post-transplant: reoperation due to bleeding, bacterial infections, liver rejection, AHT and median creatinine levels at 1st and 3rd years were similar in LKT and LT. In contrast, early post-transplant dialysis was higher in LKT than LT (31% vs. 3%; p = 0.01). Survival rates at 1st, 3rd, 5th and 7th years were similar in both groups (87.5%, 74%, 74% and 66% vs. 81%, 75%, 75% and 75% in LT and LKT, respectively).

CONCLUSIONS:

LKT is an effective therapeutic option in patients with end-stage liver and kidney disease. Most early and late complications and long-term survival are similar to those observed with LT.

PMID:
23396739
[PubMed - indexed for MEDLINE]
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