Veras Francisca Jovita de Oliveira, Coelho Gustavo Rêgo, Feitosa-Neto Bartolomeu Alves, Cerqueira João Batista Gadelha, Garcia Regina Célia F Gomes, Garcia José Huygens Parente
Department of Surgery, Federal University of Ceara, Fortaleza, CE, Brazil.
Arq Bras Cir Dig. 2014 Jan-Mar;27(1):53-5. doi: 10.1590/s0102-67202014000100013.
Combined liver-kidney transplant is a routine procedure in many transplant centers. The increase in its number coincided with the introduction in 2002 of the MELD (Model for End-stage Liver Disease) score for allocation of livers, prioritizing patients with renal dysfunction. Aim : To analyze the experience with combined liver-kidney transplantation in a liver transplant center in Brazil.
A retrospective review was conducted. All transplants were performed using grafts from deceased donors.
Sixteen combined liver-kidney transplantations were performed in the same period, which corresponds to 2.7% and 2.5% of the kidney and liver transplants, respectively. Fourteen patients were male (87.5 %) and two were female (12.5%). The average patients and donors age was 57.3 ± 9.1 and 32.7 ± 13.1, respectively. The MELD score mean was 23.6 ± 3.67. The main cause of liver dysfunction were chronic hepatitis C virus (n=9). As for renal dysfunction, diabetic nephropathy (n=4) was the most frequent. There were six deaths, two of them by severe dysfunction of the liver graft and four by infectious causes. The 1, 3 and 5 years survival rate in patients undergoing liver-kidney transplantations was 68.8%, 57.3% and 57.3%, respectively.
The survival rates achieved in this series are considered satisfactory and show that this procedure has an acceptable morbidity and survival.
肝肾联合移植在许多移植中心是一种常规手术。其数量的增加与2002年引入用于肝脏分配的终末期肝病模型（MELD）评分相吻合，该评分优先考虑肾功能不全的患者。目的：分析巴西一家肝脏移植中心肝肾联合移植的经验。
进行回顾性研究。所有移植均使用来自已故供体的移植物。
同期进行了16例肝肾联合移植，分别占肾移植和肝移植的2.7%和2.5%。14例患者为男性（87.5%），2例为女性（12.5%）。患者和供体的平均年龄分别为57.3±9.1岁和32.7±13.1岁。MELD评分均值为23.6±3.67。肝功能障碍的主要原因是慢性丙型肝炎病毒（n = 9）。至于肾功能障碍，糖尿病肾病（n = 4）最为常见。有6例死亡，其中2例死于肝移植物严重功能障碍，4例死于感染原因。肝肾移植患者的1年、3年和5年生存率分别为68.8%、57.3%和57.3%。
本系列所取得的生存率被认为是令人满意的，表明该手术具有可接受的发病率和生存率。
