Surgical aspects and outcome of combined liver and kidney transplantation in children.
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Surgical aspects and outcome of combined liver and kidney transplantation in children. / Herden, Uta; Kemper, Markus J.; Ganschow, Rainer; Klaassen, Ilka; Grabhorn, Enke; Brinkert, Florian; Nashan, Björn; Fischer, Lutz.
in: TRANSPL INT, Jahrgang 24, Nr. 8, 8, 2011, S. 805-811.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Surgical aspects and outcome of combined liver and kidney transplantation in children.
AU - Herden, Uta
AU - Kemper, Markus J.
AU - Ganschow, Rainer
AU - Klaassen, Ilka
AU - Grabhorn, Enke
AU - Brinkert, Florian
AU - Nashan, Björn
AU - Fischer, Lutz
PY - 2011
Y1 - 2011
N2 - In children with renal insufficiency and accompanying or underlying liver disease, combined liver and kidney transplantations (CLKT) are indicated. However, because of the rare indications, the number of paediatric CLKT is low. Our aim was to analyse CLKT in children with special regard to surgical aspects and outcome. All paediatric CLKT performed at our institution between 1998 and 2009 were retrospectively analysed. Between 1998 and 2009, 15 CLKT were performed in 14 paediatric patients (median age 8 years, range 1-16 years). The indications for CLKT were autosomal recessive polycystic kidney disease (n = 7), primary hyperoxaluria type 1 (n = 7) and retransplantation because of primary liver nonfunction (n = 1). In the postoperative course, six patients showed bleeding complications, thereof three patients needed operative revision for intra-abdominal bleeding. Eight of 15 patients (53%) needed dialysis. The 1- and 5-year patient survival was 100%; and 1- and 5-year graft survival was 80% for the liver and 93% for the kidney allograft. A number of different complications, especially secondary haemorrhage have to be anticipated after CLKT, requiring a timely and interdisciplinary treatment approach. With this management, our patients showed an excellent graft and patient survival.
AB - In children with renal insufficiency and accompanying or underlying liver disease, combined liver and kidney transplantations (CLKT) are indicated. However, because of the rare indications, the number of paediatric CLKT is low. Our aim was to analyse CLKT in children with special regard to surgical aspects and outcome. All paediatric CLKT performed at our institution between 1998 and 2009 were retrospectively analysed. Between 1998 and 2009, 15 CLKT were performed in 14 paediatric patients (median age 8 years, range 1-16 years). The indications for CLKT were autosomal recessive polycystic kidney disease (n = 7), primary hyperoxaluria type 1 (n = 7) and retransplantation because of primary liver nonfunction (n = 1). In the postoperative course, six patients showed bleeding complications, thereof three patients needed operative revision for intra-abdominal bleeding. Eight of 15 patients (53%) needed dialysis. The 1- and 5-year patient survival was 100%; and 1- and 5-year graft survival was 80% for the liver and 93% for the kidney allograft. A number of different complications, especially secondary haemorrhage have to be anticipated after CLKT, requiring a timely and interdisciplinary treatment approach. With this management, our patients showed an excellent graft and patient survival.
KW - Humans
KW - Male
KW - Female
KW - Adolescent
KW - Treatment Outcome
KW - Child
KW - Child, Preschool
KW - Infant
KW - Infant, Newborn
KW - Postoperative Complications
KW - Graft Survival
KW - Hyperoxaluria, Primary/therapy
KW - Kidney Transplantation/methods
KW - Liver Transplantation/methods
KW - Polycystic Kidney Diseases/therapy
KW - Portal Vein/pathology
KW - Renal Dialysis
KW - Humans
KW - Male
KW - Female
KW - Adolescent
KW - Treatment Outcome
KW - Child
KW - Child, Preschool
KW - Infant
KW - Infant, Newborn
KW - Postoperative Complications
KW - Graft Survival
KW - Hyperoxaluria, Primary/therapy
KW - Kidney Transplantation/methods
KW - Liver Transplantation/methods
KW - Polycystic Kidney Diseases/therapy
KW - Portal Vein/pathology
KW - Renal Dialysis
M3 - SCORING: Journal article
VL - 24
SP - 805
EP - 811
JO - TRANSPL INT
JF - TRANSPL INT
SN - 0934-0874
IS - 8
M1 - 8
ER -