Combined liver-kidney transplant beneficial for patients with dual org...( nted livers and 76 percent of the trans...),Health

nted livers and 76 percent of the transplanted kidneys survived after one year; after three years, 65 percent of the livers and 72 percent of the kidneys; and after five years, 65 percent of the livers and 70 percent of the kidneys. Among those who underwent kidney transplants only, 23 percent of the kidneys were rejected by the recipient's body after one year, compared with 14 percent of those who had liver-kidney transplants.

When compared with hepatorenal syndrome patients who received only liver transplants, those who were undergoing dialysis--use of a machine to perform the blood filtration normally handled by the kidneys--for longer than eight weeks before surgery did better after the combined transplant. "Before this analysis, we recommended combined liver and kidney transplantation when patients receive hemodialysis for longer than one month before transplantation," the authors write. "However, on the basis of current findings, we find that the acuteness of renal failure subsides after two months of hemodialysis and that combined liver and kidney transplantation after this time will not only offer improvement in patient survival but also reduce hospital expenditures for patient care."

"Combined kidney and liver transplantation offers the best option for patients with simultaneous chronic liver and kidney failure when it is performed at a high-volume academic transplant center," they conclude.
(Arch Surg. 2006;141:735-742. Available pre-embargo to the media at http://www.jamamedia.org.)

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Contact: Elaine Schmidt
310-794-2272
JAMA and Archives Journals
21-Aug-2006

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