COMBINED LIVER-KIDNEY TRANSPLANTATION: EXPERIENCE AT A BRAZILIAN UNIVERSITY HOSPITAL

Background

Combined liver-kidney transplant is a routine procedure in many transplantcenters. The increase in its number coincided with the introduction in 2002 of theMELD (Model for End-stage Liver Disease) score for allocation of livers,prioritizing patients with renal dysfunction.

Aim

To analyze the experience with combined liver-kidney transplantation in a livertransplant center in Brazil.

Method

A retrospective review was conducted. All transplants were performed using graftsfrom deceased donors.

Results

Sixteen combined liver-kidney transplantations were performed in the same period,which corresponds to 2.7% and 2.5% of the kidney and liver transplants,respectively. Fourteen patients were male (87.5 %) and two were female (12.5%).The average patients and donors age was 57.3±9.1 and 32.7±13.1,respectively. The MELD score mean was 23.6±3.67. The main cause of liverdysfunction were chronic hepatitis C virus (n=9). As for renal dysfunction,diabetic nephropathy (n=4) was the most frequent. There were six deaths, two ofthem by severe dysfunction of the liver graft and four by infectious causes. The1, 3 and 5 years survival rate in patients undergoing liver-kidneytransplantations was 68.8%, 57.3% and 57.3%, respectively.

Conclusion

The survival rates achieved in this series are considered satisfactory and showthat this procedure has an acceptable morbidity and survival.