Jesús Quintero Bernabeu1, Javier Juamperez2, Marina Muñoz3, Olalla Rodriguez4, Ramon Vilalta3, José A Molino5, Marino Asensio5, Itxarone Bilbao6, Gema Ariceta3, Carlos Rodrigo4, Ramón Charco6. 1. Pediatric Hepatology and Liver Transplant Unit, Hospital Universitari Vall d'Hebron, Universitat Atònoma de Barcelona, 08035, Barcelona, Spain. 38633jqb@gmail.com. 2. Pediatric Hepatology and Liver Transplant Unit, Hospital Universitari Vall d'Hebron, Universitat Atònoma de Barcelona, 08035, Barcelona, Spain. 3. Pediatric Nephrology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, 08035, Barcelona, Spain. 4. Pediatrics Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, 08035, Barcelona, Spain. 5. Pediatric Surgery Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, 08035, Barcelona, Spain. 6. HPB Surgery and Transplants, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, 08035, Barcelona, Spain.
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.
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.
Authors: A Demetris; D Adams; C Bellamy; K Blakolmer; A Clouston; A P Dhillon; J Fung; A Gouw; B Gustafsson; H Haga; D Harrison; J Hart; S Hubscher; R Jaffe; U Khettry; C Lassman; K Lewin; O Martinez; Y Nakazawa; D Neil; O Pappo; M Parizhskaya; P Randhawa; S Rasoul-Rockenschaub; F Reinholt; M Reynes; M Robert; A Tsamandas; I Wanless; R Wiesner; A Wernerson; F Wrba; J Wyatt; H Yamabe Journal: Hepatology Date: 2000-03 Impact factor: 17.425
Authors: R Shapiro; I Weismann; H Mandel; B Eisenstein; Z Ben-Ari; N Bar-Nathan; I Zehavi; G Dinari; E Mor Journal: Transplantation Date: 2001-08-15 Impact factor: 4.939
Authors: James M Gloor; Steven DeGoey; Nancy Ploeger; Howard Gebel; Robert Bray; S Breanndan Moore; Patrick G Dean; Mark D Stegall Journal: Transplantation Date: 2004-07-27 Impact factor: 4.939
Authors: Elisabeth L Metry; Liza M M van Dijk; Hessel Peters-Sengers; Michiel J S Oosterveld; Jaap W Groothoff; Rutger J Ploeg; Vianda S Stel; Sander F Garrelfs Journal: Pediatr Nephrol Date: 2021-04-08 Impact factor: 3.714