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Liver-kidney transplant reduces organ rejection, boosts recovery

New UCLA research shows that combined liver-kidney transplants appear to benefit patients with diseases in both organs, including patients with potentially reversible kidney failure who have been receiving dialysis for longer than two months. The Archives of Surgery will publish the findings in its August issue.

"Our study indicates that a combined liver-kidney transplant is the procedure of choice for patients suffering end-stage disease in both the liver and kidneys," explained Dr. Ronald Busuttil, professor and chair of surgery at the David Geffen School of Medicine at UCLA. "For the first time, it also appears that a dual-organ transplant can help liver-disease patients with temporary kidney dysfunction."

Hepatorenal syndrome -- potentially reversible kidney failure caused by cirrhosis or another liver disease -- is often treated by liver transplant alone, not a combined procedure. As waiting times for organs rise, however, hepatorenal-syndrome patients face an increased risk of developing a chronic, irreversible condition that may require a combination transplant.

Busuttil and his colleagues reviewed data from 98 patients who underwent 99 combined liver-kidney transplants at the Dumont-UCLA Transplant Center in the Pfleger Liver Institute from 1988 to 2004. The patients' average age was 46 years; 76 suffered from primary kidney diseases and 22 had hepatorenal syndrome.

For comparison, the researchers also reviewed data from 148 patients with hepatorenal syndrome who underwent only a liver transplant between 1998 and 2002, and 743 patients who received only a kidney transplant.

Of the 99 combined-transplant patients, 31 had died. The survival rates at one, three and five years after surgery were 76, 72 and 70 percent, respectively. None of the risk factors analyzed by the UCLA team, including donor characteristics, recipient age or previous transplants, influenced the patient's survival rate after surgery.
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Contact: Elaine Schmidt
eschmidt@mednet.ucla.edu
310-794-2272
University of California - Los Angeles
21-Aug-2006


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