Successful long-term outcome of pediatric liver–kidney transplantation: a single-center study

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 transplantati...

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Published in:Pediatric nephrology (Berlin, West) West), 2018-02, Vol.33 (2), p.351-358
Main Authors: Quintero Bernabeu, Jesús, Juamperez, Javier, Muñoz, Marina, Rodriguez, Olalla, Vilalta, Ramon, Molino, José A., Asensio, Marino, Bilbao, Itxarone, Ariceta, Gema, Rodrigo, Carlos, Charco, Ramón
Format: Article
Language:English
Subjects:
Adolescent
Analysis
Child
Children
End-stage renal disease
Female
Graft rejection
Graft Survival
Health aspects
Humans
Hyperglycemia
Hyperoxaluria
Hyperoxaluria, Primary - surgery
Hypertension, Portal - surgery
Kidney diseases
Kidney Failure, Chronic - surgery
Kidney transplantation
Kidney Transplantation - methods
Kidney transplants
Liver diseases
Liver transplantation
Liver Transplantation - methods
Male
Medical records
Medicine
Medicine & Public Health
Nephrology
Original Article
Patients
Pediatrics
Polycystic kidney
Polycystic Kidney, Autosomal Recessive - surgery
Primary hyperoxaluria
Renal function
Retrospective Studies
Time
Transplants & implants
Treatment Outcome
Urology
What’s New in Renal Transplantation
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Summary: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  
ISSN:0931-041X
1432-198X
DOI:10.1007/s00467-017-3782-5