Three cases of sequential liver–kidney transplantation fromliving‐related donors

Nakamura, Michio; Fuchinoue, Shohei; Nakajima, Ichiro; Kitajima, Kumiko; Tojimbara, Tamotsu; Takasaki, Ken; Saito, Hiroshi; Ito, Katsuhiko; Tanaka, Kōichi; Agishi, T

doi:10.1093/ndt/16.1.166

Cited by 34 publications

(37 citation statements)

References 8 publications

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“…5,[7][8][9][10][11][18][19][20][21][22] To date, few other studies have reported the outcome of LDLT for PSC from biologically related donors. [23][24][25][26][27][28][29][30][31][32] Yamigawa et al reviewed 66 patients with PSC who underwent LDLT in Japan. The 5-year survival rate was 72%, and the rate of recurrence diagnosed on histological and cholangiographic findings was 25%.…”

Section: Discussionmentioning

confidence: 99%

Comparative Analysis of Outcomes in Living and Deceased Donor Liver Transplants for Primary Sclerosing Cholangitis

Kashyap

Mantry

Sharma

et al. 2009

Journal of Gastrointestinal Surgery

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Introduction Primary sclerosing cholangitits (PSC) is a progressive fibrosing cholangiopathy eventually leading to endstage liver disease (ESLD). While literature for deceased donor liver transplantation (DDLT) for PSC abounds, only a few reports describe live donor liver transplant (LDLT) in the setting of PSC. We present a single-center experience on survival outcomes and disease recurrence for LDLT and DDLT for ESLD secondary to PSC. Aim The aim of this study was to analyze survival outcomes and disease recurrence for LDLT and DDLT for ESLD secondary to PSC. Patients and Methods A retrospective review of 58 primary liver transplants for PSC-associated ESLD, performed between May 1995 and January 2007, was done. Patients were divided into two groups based on donor status. Group 1 (n=14) patients received grafts from living donors, while group 2 (n=44) patients received grafts from deceased donors. An analysis of survival outcomes and disease recurrence was performed. Recurrence was confirmed based on radiological and histological criteria. Results Recurrence of PSC was observed in four patients in LDLT group and seven in DDLT group. Retransplantation was required in one patient in LDLT group and nine patients in DDLT group. One patient (7%) among LDLT and six patients (14%) among DDLT died. The difference in patient and graft survival was not statistically significant between the two groups (patient survival, p=0.60; graft survival, p=0.24). Conclusion This study demonstrates equivalent survival outcomes between LDLT and DDLT for PSC; however, the rate of recurrence may be higher in patients undergoing LDLT.

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Section: Discussionmentioning

confidence: 99%

Comparative Analysis of Outcomes in Living and Deceased Donor Liver Transplants for Primary Sclerosing Cholangitis

Kashyap

Mantry

Sharma

et al. 2009

Journal of Gastrointestinal Surgery

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“…Recently, sequential LKT from same living donor was reported in three children with chronic liver disease and renal failure. 5 The authors have advocated postponing KT until the clinical condition and liver function have become stabile. Finally, a simultaneous combined LKT from a same living donor for a patient with rapidly deteriorating hepatitis B virus cirrhosis and ESRF has been reported.…”

Section: Discussionmentioning

confidence: 99%

“…Partial LT alone or sequential LKT from living donors have been successfully performed for PH1. 4,5 To date, there have been no reports describing combined simultaneous LKT from the same living donor in the treatment of PH1 complicated with ESRF. …”

mentioning

confidence: 99%

Primary hyperoxaluria: Simultaneous combined liver and kidney transplantation from a living related donor

Astarcıoğlu

Karademir

Gülay

et al. 2003

Liver Transplantation

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Primary hyperoxaluria type 1 (PH1) is a rare inherited metabolic disorder in which deficiency of the liver enzyme AGT leads to renal failure and systemic oxalosis. Timely, combined cadaveric liver-kidney transplantation (LKT) is recommended for end-stage renal failure (ESRF) caused by PH1; however, the shortage of cadaveric organs has generated enthusiasm for living-related transplantation in years. Recently, successful sequential LKT from the same living donor has been reported in a child with PH1. We present a sister-to-brother simultaneous LKT in a pediatric patient who suffered from PH1 with ESRF. Twelve months after transplantation, his daily urine oxalate excretion was decreased from 160 mg to 19.5 mg with normal liver and renal allograft functions. In addition to the well-known advantages of living organ transplantation, simultaneous LKT may facilitate early postoperative hemodynamic stability and may induce immunotolerance and allow for low-dose immunosuppression. (Liver Transpl 2003;9:433-436.) P rimary hyperoxaluria type 1 (PH1) is a rare, inherited metabolic disorder caused by a deficiency of the liver-specific peroxisomal alanine-glyoxylate aminotransferase (AGT). It is characterized by increased synthesis and urinary excretion of oxalate that leads to renal failure attributable to urolithiasis, nephrocalcinosis, and, subsequently, to oxalate accumulation in various extra-renal tissues such as the skeleton and the cardiovascular system. Because the liver is the site of the metabolic defect, isolated kidney transplantation (KT) is not a reasonable therapeutic alternative because of a rapid diffuse oxalate deposition in the allograft. 1 Preemptive liver transplantation (LT) has been successfully performed in some children before serious renal damage occurred. 2 If end-stage renal failure (ESRF) has been reached, early simultaneous or sequential liver-KT (LKT) may avoid the deleterious consequences of systemic oxalosis. 3 Shortage of donor organs remains the critical factor limiting the use of organ transplantation. This shortage has generated enthusiasm for living-related transplantation, offering hope not only for children but also for adolescents and even adults. Partial LT alone or sequential LKT from living donors have been successfully performed for PH1. 4,5 To date, there have been no reports describing combined simultaneous LKT from the same living donor in the treatment of PH1 complicated with ESRF.

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“…Since then, there have been sporadic case reports of LDLT for PSC from living related donors (26)(27)(28)(29)(30)(31)(32)(33)(34) (Figure 1). However, follow-up periods were less than 2 years in most case reports, and recurrence was not reported.…”

Section: Recurrence Of Psc In Ldltmentioning

confidence: 99%

Primary sclerosing cholangitis as an intractable disease

Tamura

Sugawara

Kokudo

2012

Intractable Rare Dis Res

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Three cases of sequential liver–kidney transplantation fromliving‐related donors

Cited by 34 publications

References 8 publications

Comparative Analysis of Outcomes in Living and Deceased Donor Liver Transplants for Primary Sclerosing Cholangitis

Comparative Analysis of Outcomes in Living and Deceased Donor Liver Transplants for Primary Sclerosing Cholangitis

Primary hyperoxaluria: Simultaneous combined liver and kidney transplantation from a living related donor

Primary sclerosing cholangitis as an intractable disease

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