The First Case Series of Combined Liver-Kidney Transplantation (CLKT) from Thailand
| Autor: | Vasant Sumethkul, Somchai Viengteerawat, PiyanutPootracool, Pongphob Intaraprasong, Sasinee Tongprasert, Piyaporn Kaewdoung, Abhasnee Sobhonslidsuk, Supanna Petraksa, Suthus Sriphojanart, Napat Angkathunyakul, Surasak Leelaudomlipi, Pattana Sornmayura |
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| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
Creatinine Cirrhosis business.industry medicine.medical_treatment Hepatitis C Hepatitis B medicine.disease Gastroenterology Tacrolimus Surgery chemistry.chemical_compound chemistry Internal medicine medicine Prednisolone Hemodialysis business Acute tubular necrosis medicine.drug |
| Zdroj: | Journal of Gastrointestinal & Digestive System. |
| ISSN: | 2161-069X |
| Popis: | From the hospital database, four patients underwent CLKT. Three patients had ESRD and cirrhosis. Causes of cirrhosis were chronic hepatitis B and chronic hepatitis C in two and one patient. The fourth patient underwent CLKT due to subfulminant liver failure and prolonged acute renal failure with severely damaged kidney and required hemodialysis for 5 weeks. The waiting time ranged from 6 to 1988 days. After CLKT, one patient required hemodialysis for 45 days because of prolonged acute tubular necrosis. Mild early liver graft dysfunction occurred in one patient. Induction regimens were IL2-receptor blockers, steroids and tacrolimus in three patients, and steroids combining with tacrolimus in one patient. Maintenance regimens included tacrolimus, mycophenolate mofetil (with or without low-dose prednisolone). One-year graft and patient survival rate was 100%. Median follow-up time was 2.2 years. None developed liver or renal graft rejection. At 6 and 12 months, median creatinine levels were 1.30 and 1.13 mg/dl. At the last visits, median creatinine level was 1.05 mg/dl with median eGFR of 76.45 ml/min. CLKT may be done in the patients with ESRD and viral hepatitis-related cirrhosis even without portal hypertension. Other indication is for patients with acute liver failure with severely damaged ARF. |
| Databáze: | OpenAIRE |
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