Liver and kidney transplantation in polycystic liver and kidney disease
Liver and kidney transplantation in polycystic liver and kidney disease
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DOI：
10.1016/j.gastrohep.2020.12.004
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发表时间：
2021-10-01
影响因子：
1.9
通讯作者：
Navasa, Miguel
中科院分区：
文献类型：
--
作者：
Faride Rodriguez-Aguilar, Erika;Sastre, Lydia;Navasa, Miguel
目的：回顾性分析32例肝肾疾病患者行单纯肝移植和肝肾联合移植的结果。一项回顾性观察性研究，入组了多囊肝病（PLD）和多囊肝肾疾病（PLKD）患者在1999年1月至2019年12月期间在巴塞罗那临床医院[巴塞罗那临床医院]接受移植评估的患者。结果：在入组的53名患者中，32名（60.3%）有移植指征，12名接受了单次肝移植，20名接受了双次肝和肾移植。平均年龄为52岁，83.9%的接受者为女性。肝移植的主要适应症是致残性症状性肝肿大（93.5%）。术后并发症中，肝肾联合移植组出现肝动脉血栓形成和肾动脉血栓形成。两组均存在下腔静脉病变。3例患者出现对皮质类固醇有反应的急性细胞性排斥反应，1例出现体液性排斥反应，经血浆置换治疗。在80（27-121）个月的随访期间，肝移植存活率为100%，肾移植存活率为90%。肝肾联合移植组中有2例患者死亡（1例死于心血管疾病，另1例死于肠腺癌）。结论：选择性多囊性疾病患者行单纯肝移植或肝肾联合移植可获得良好的效果，并发症少，移植物存活率和患者存活率均非常高（93.8%）。(C)2021 Elsevier Espana，S.L.U. All rights reserved.
Objective: To evaluate the results of isolated liver and combined liver and kidney transplantation in a retrospective series of 32 patients with hepatorenal liver and kidney disease.Patients and methods: A retrospective observational study that enrolled patients with polycystic liver disease (PLD) and polycystic liver and kidney disease (PLKD) who were evaluated for transplantation between January 1999 and December 2019 at Hospital Clinic de Barcelona [Clinical Hospital of Barcelona].Results: Of 53 patients enrolled, 32 (60.3%) had an indication for transplantation, 12 received a single liver transplant and 20 received a double liver and kidney transplant. The mean age was 52 years and 83.9% of the recipients were women. The main indication for liver transplantation was disabling symptomatic hepatomegaly (93.5%). Among the postoperative complications, in the combined liver and kidney transplant group, hepatic artery thrombosis and renal artery thrombosis were detected. In both groups there was an inferior vena cava lesion. Three patients presented acute cellular rejection responding to corticosteroids and one presented humoral rejection which was treated with plasmapheresis. During the follow-up period of 80 (27-121) months, the liver transplant survival rate was 100% and the kidney transplant survival rate was 90%. Two patients in the combined liver and kidney transplant group died (one due to cardiovascular causes and the other due to intestinal adenocarcinoma).Conclusions: Isolated liver transplantation or combined liver and kidney transplantation in selected patients with polycystic disease yields excellent results, with few complications, very good transplant survival and excellent patient survival (93.8%). (C) 2021 Elsevier Espana, S.L.U. All rights reserved.