Rodríguez-Aguilar Erika Faride, Sastre Lydia, Colmenero Jordi, García-Valdecasas Juan Carlos, Fondevila Constantino, García Juárez Ignacio, Navasa Miquel
Unidad de Trasplante Hepático, Servicio de Hepatología, Hospital Clínic de Barcelona, IDIBAPS, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, España.
Departamento de Cirugía, Universidad de Barcelona, IDIBAPS, CIBEREHD, Unidad de Trasplante Hepático, Hospital Clínic de Barcelona, Barcelona, España.
Gastroenterol Hepatol. 2021 Oct;44(8):552-558. doi: 10.1016/j.gastrohep.2020.12.004. Epub 2021 Feb 3.
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.
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 Clínic de Barcelona [Clinical Hospital of Barcelona].
We included a total of 53 patients enrolled, 32 (60.3%) had indication for transplantation, of which 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 in one case and renal artery thrombosis in other were detected. In both groups there was one case of 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).
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%).
回顾性分析32例肝肾疾病患者接受单纯肝移植及肝肾联合移植的结果。
一项回顾性观察研究，纳入1999年1月至2019年12月期间在巴塞罗那临床医院接受移植评估的多囊肝病（PLD）和多囊肝肾疾病（PLKD）患者。
共纳入53例患者，其中32例（60.3%）有移植指征，12例接受单纯肝移植，20例接受肝肾联合移植。患者平均年龄52岁，83.9%为女性。肝移植的主要指征是导致功能障碍的有症状肝肿大（93.5%）。术后并发症方面，肝肾联合移植组中，1例发生肝动脉血栓形成，另1例发生肾动脉血栓形成。两组各有1例下腔静脉病变。3例患者出现急性细胞排斥反应，对皮质类固醇治疗有效，1例出现体液排斥反应，接受血浆置换治疗。在80（27 - 121）个月的随访期内，肝移植生存率为100%，肾移植生存率为90%。肝肾联合移植组有2例患者死亡（1例死于心血管原因，另1例死于肠道腺癌）。
对于选定的多囊疾病患者，单纯肝移植或肝肾联合移植效果良好，并发症少，移植存活率高，患者存活率极佳（93.8%）。
