
Journal Basic Info
- Impact Factor: 1.995**
- H-Index: 8
- ISSN: 2474-1647
- DOI: 10.25107/2474-1647
Major Scope
- Vascular Surgery
- Thoracic Surgery
- Otolaryngology - Head and Neck Surgery
- Neurological Surgery
- Gynecological Surgery
- Colon and Rectal Surgery
- Oral and Maxillofacial Surgery
- Cardiovascular Surgery
Abstract
Citation: Clin Surg. 2017;2(1):1352.Review Article | Open Access
Combined Liver Kidney Transplantation in Pediatrics: Indications, Special Considerations, and Outcomes
David Cha, Katherine Concepcion, Amy Gallo and Waldo Concepcion
Department of Multi Organ Transplantation, Stanford University School of Medicine, USA
Department of Surgery, Loma Linda University School of Medicine, USA
*Correspondance to: Waldo Concepcion
PDF Full Text DOI: 10.25107/2474-1647.1352
Abstract
Combined liver and kidney transplants (CLKTs) are not commonly performed in pediatric patients. Advancing the medical community’s understanding of when these procedures may be the optimal choice for pediatric patients and when other options may be preferable is crucial. There are three main pediatric groups who may be considered candidates for CLKT: (1) those who suffer a disease that leads to irreversible liver and kidney damage‒including autosomal recessive polycystic kidney disease; (2) those with end-stage renal disease caused by a liver-based metabolic disease‒ including primary hyperoxaluria types 1 and 2, methylmalonic acidemia, and atypical hemolytic uremic syndrome; and (3) those who present with concomitant liver and kidney failure‒including patients with Boichis syndrome (nephronophthisis plus congenital hepatic fibrosis) or with liver tumor plus nephrotoxicity. We review here the indications and special considerations related to CLKT for patients in each of these groups and the outcomes seen to date in these pediatric patient groups. With the appropriate donor selection, family education, and medical team commitment CLKT has been shown to be and, we believe, will continue to be an outstanding option for medical management in this select group of patients. Continued advances pre-transplant, intra-operatively and post-transplant will be required to optimize success.
Keywords
Combined liver kidney transplantation; Simultaneous liver kidney transplantation; Autosomal recessive polycystic kidney disease; Primary hyperoxaluria, methylmalonic acidemia; Atypical hemolytic uremic syndrome; Boichis syndrome, Concomitant liver and kidney failure
Cite the article
Cha D, Concepcion K, Gallo A, Concepcion W. Combined Liver Kidney Transplantation in Pediatrics: Indications, Special Considerations, and Outcomes. Clin Surg. 2017; 2: 1352.