Kidney transplantation combined with other organs in Bologna: an update.

Autor: Bertelli R; Department of Surgery, Intensive Care and Transplantation, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. riccardobertelli@hotmail.com, Nardo B, Cavallari G, Ercolani G, Lauro A, Neri F, Tsivian M, Grazi GL, Mikus PM, Pilato E, Mikus E, Arpesella G, Pinna AD, Stefoni S, Fuga G, Faenza A
Jazyk: angličtina
Zdroj: Transplantation proceedings [Transplant Proc] 2008 Jul-Aug; Vol. 40 (6), pp. 1867-8.
DOI: 10.1016/j.transproceed.2008.05.024
Abstrakt: Background: We retrospectively reviewed our experience in combined liver-kidney (L-KT) and heart-kidney (H-KT) transplantations.
Patients and Methods: Between January 1997 and April 2007, we performed 25 L-KT and 5 H-KT. Patient mean age was 51+/-8 years in L-KT and 43+/-11 years in H-KT. The main cause of liver failure was chronic viral hepatitis (14 cases). Etiology of heart failure was dilated cardiomyopathy and hypertrophic cardiomyopathy (4 and 1 patients, respectively). The main causes of renal failure in L-KT were chronic glomerulonephritis (n=8) and polycystic disease (n=7). Etiology of renal failure in H-KT was interstitial nephropathy (n=2), vascular nephropathy (n=2), and chronic glomerulonephritis (n=1).
Results: Mean follow-up was 32+/-26 months in L-KT and 24+/-17 months in H-KT. Immunosuppression was cyclosporine-based (n=4) or tacrolimus-based (n=21) in L-KT and cyclosporine-based in H-KT. Acute rejection rate was 8% for both liver and kidney in L-KT; 80% (mild) for heart and 40% for kidney in H-KT. In the L-KT group, there was no primary graft nonfunction (PGNF). Two patients experienced liver delayed graft function (DGF); 1 patient required postoperative dialysis. One-year graft and patient survivals were both 84% and overall graft and patient survival was 76%. In the H-KT group, 3 patients needed postoperative dialysis and 1 required a cardiac assistance device for 48 hours; overall graft and patient survival was 100% with good cardiac and renal functions.
Conclusion: Our experience confirmed that H-KT and L-KT are safe procedures, offering good long-term results.
Databáze: MEDLINE
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