Pediatric combined liver-kidney transplantation: a single-center experience of 18 cases.

Background: Experience in combined liver-kidney transplantation (CLKT) in children is limited. Methods: We conducted a retrospective study of all pediatric CLKTs performed at our medical institution between 1992 and 2013. Results: We identified 18 pediatric patients (9 girls) who had undergone CLKT...

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Publicado en:Pediatric Nephrology Vol. 31; no. 9; pp. 1517 - 1530
Autores principales: Duclaux-Loras, Rémi, Bacchetta, Justine, Berthiller, Julien, Rivet, Christine, Demède, Delphine, Javouhey, Etienne, Dubois, Rémi, Dijoud, Frédérique, Lachaux, Alain, Badet, Lionel, Boillot, Olivier, Cochat, Pierre
Formato: research tables/charts Journal Article
Publicado: Springer Nature Sep2016
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep2016
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00467-016-3324-6
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        atl: Pediatric combined liver-kidney transplantation: a single-center experience of 18 cases.
      aug:
        au:
          Duclaux-Loras, Rémi
          Bacchetta, Justine
          Berthiller, Julien
          Rivet, Christine
          Demède, Delphine
          Javouhey, Etienne
          Dubois, Rémi
          Dijoud, Frédérique
          Lachaux, Alain
          Badet, Lionel
          Boillot, Olivier
          Cochat, Pierre
        affil: Information Médicale Evaluation Recherche, Hospices Civils de Lyon, Lyon France
      sug:
        subj:
          Child Health
          Liver Transplantation Evaluation
          Kidney Transplantation Evaluation
          Outcomes (Health Care)
          Human
          Retrospective Design
          Female
          Male
          Descriptive Statistics
          Child, Preschool
          Child
          Adolescence
          Survival Analysis
          Glomerular Filtration Rate
          Oxalic Acids Urine
          Creatinine Urine
          Metabolism, Inborn Errors Complications
          Kidney Failure, Chronic Complications
          Child, Preschool: 2-5 years
          Child: 6-12 years
          Adolescent: 13-18 years
          Female
          Male
      ab: Background: Experience in combined liver-kidney transplantation (CLKT) in children is limited. Methods: We conducted a retrospective study of all pediatric CLKTs performed at our medical institution between 1992 and 2013. Results: We identified 18 pediatric patients (9 girls) who had undergone CLKT at our institution during the study period. The median age [range] and body weight [range] of this patient group was 3.6 [1.0-18.6] years and 13 [10-40] kg, respectively; 11 patients weighed <15 kg at the time of CLKT. Indications for CLKT were primary hyperoxaluria (PH1; n = 14), association of hepatic fibrosis and end-stage renal disease ( n = 3) and methylmalonic acidemia ( n = 1). In the early postoperative period, eight patients required dialysis. Median stay in the pediatric intensive care unit was 10 [6-29] days. One patient died from cardiovascular disease 10 years after CLKT. There were no liver graft losses despite six acute liver rejection episodes, whereas four kidney grafts were lost. At last follow-up (6 [0.5-21] years) for patients with a functioning renal graft, the glomerular filtration rate was 71 [26-146] mL/min/1.73 m. In PH1 patients, urine oxalate normalized in six patients within 3 years after CLKT, but three patients still presented with elevated oxaluria at 1, 2 and 3 years after CLKT. Conclusions: Pediatric CLKT provides encouraging results in the long term, even in the youngest patients.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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