Combined liver and kidney transplantation in children and long-term outcome

• 作者: Kavinda Dayasiri Manoji Gamage Randula Ranawaka
• 来源期刊: 世界移植杂志
• 学科: 医学
• 关键词: Combined liver-kidney transplantation IMMUNOPROTECTION Long-term outcomes Renal allograft survival Acute cellular rejection Autosomal recessive polycystic kidney disease
• 年，卷（期）: sjyzzz_2020,（10）
• 页码范围: 283-290
• 页数: 8页
• 分类号: R69

摘要

Combined liver-kidney transplantation(CLKT)is a rarely performed complex surgical procedure in children and involves transplantation of kidney and either whole or part of liver donated by the same individual(usually a cadaver)to the same recipient during a single surgical procedure.Most common indications for CLKT in children are autosomal recessive polycystic kidney disease and primary hyperoxaluria type 1.Atypical haemolytic uremic syndrome,methylmalonic academia,and conditions where liver and renal failure co-exists may be indications for CLKT.CLKT is often preferred over sequential liver-kidney transplantation due to immunoprotective effects of transplanted liver on renal allograft;however,liver survival has no significant impact.Since CLKT is a major surgical procedure which involves multiple and complex anastomosis surgeries,acute complications are not uncommon.Bleeding,thrombosis,haemodynamic instability,infections,acute cellular rejections,renal and liver dysfunction are acute complications.The long-term outlook is promising with over 80%5-year survival rates among those children who survive the initial six-month postoperative period.