Polycystic disease causes a progressive decrease in renal function and liver degeneration. The progression of the disease evolves separately between organs and transplantation options vary: simultaneous or sequential liver-kidney transplantation or single-organ transplantation. From September 2006 to June 2007 3 combined liver kidney transplantations (CLKT) were performed for polycystic disease with end-stage renal disease: 2 with polycystic liver disease, and I with hepatic failure due to congenital hepatic fibrosis. The widest dimensions of the polycystic liver of 50 and 60 cm diameter were due to extensive cystic degeneration. We performed 1 simultaneous CLKT and 2 sequential transplantations: I liver after kidney, and 1 kidney after liver. At present all patients are alive with 100% graft function. Median creatinine level at discharge was 0.9 mg/dL (ranges, +/- 0.2). Good liver graft function was reported in all 3 cases. Transplant benefit in polycystic liver-kidney disease has been already demonstrated; conservative surgical options may result in a high incidence of complications in highly involved polycystic livers. Delaying transplantation results in a more difficult surgical technique, a higher rate of postoperative complications, and a disturbance of optimal graft retrieval because of the worse preoperative condition of the patients.

Combined Liver-Kidney Transplantation in Polycystic Disease: Case Reports / Rossi, Massimo; Spoletini, Gabriele; A., Bussotti; Lai, Quirino; D., Travaglia; Ferretti, Stefano; Poli, Luca; GINANNI CORRADINI, Stefano; Merli, Manuela; Novelli, Gilnardo; Mennini, Gianluca; Pugliese, Francesco; Berloco, Pasquale Bartolomeo. - In: TRANSPLANTATION PROCEEDINGS. - ISSN 0041-1345. - STAMPA. - 40:6(2008), pp. 2075-2076. ((Intervento presentato al convegno 31st Congress of the Italian-Transplantation-Society tenutosi a Modena, ITALY nel NOV 28-30, 2007 [10.1016/j.transproceed.2008.05.058].

Combined Liver-Kidney Transplantation in Polycystic Disease: Case Reports

ROSSI, MASSIMO;SPOLETINI, GABRIELE;LAI, QUIRINO;FERRETTI, Stefano;POLI, Luca;GINANNI CORRADINI, Stefano;MERLI, Manuela;NOVELLI, Gilnardo;MENNINI, Gianluca;PUGLIESE, Francesco;BERLOCO, Pasquale Bartolomeo
2008

Abstract

Polycystic disease causes a progressive decrease in renal function and liver degeneration. The progression of the disease evolves separately between organs and transplantation options vary: simultaneous or sequential liver-kidney transplantation or single-organ transplantation. From September 2006 to June 2007 3 combined liver kidney transplantations (CLKT) were performed for polycystic disease with end-stage renal disease: 2 with polycystic liver disease, and I with hepatic failure due to congenital hepatic fibrosis. The widest dimensions of the polycystic liver of 50 and 60 cm diameter were due to extensive cystic degeneration. We performed 1 simultaneous CLKT and 2 sequential transplantations: I liver after kidney, and 1 kidney after liver. At present all patients are alive with 100% graft function. Median creatinine level at discharge was 0.9 mg/dL (ranges, +/- 0.2). Good liver graft function was reported in all 3 cases. Transplant benefit in polycystic liver-kidney disease has been already demonstrated; conservative surgical options may result in a high incidence of complications in highly involved polycystic livers. Delaying transplantation results in a more difficult surgical technique, a higher rate of postoperative complications, and a disturbance of optimal graft retrieval because of the worse preoperative condition of the patients.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11573/362063
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