Combined paediatric liver-kidney transplantation: analysis of our experience

Show simple item record

dc.contributor.author Strobele, Bernd
dc.date.accessioned 2014-08-27T13:32:35Z
dc.date.available 2014-08-27T13:32:35Z
dc.date.issued 2014-08-27
dc.identifier.uri http://hdl.handle.net/10539/15312
dc.description Thesis (M.Med.(General Surgery)--University of the Witwatersrand, Faculty of Health Sciences, 2014.
dc.description.abstract Background. Renal insufficiency is increasingly common in end-stage liver disease and allocation of livers to this category of patient has escalated. The frequency of combined liver-kidney transplantation (CLKT) has consequently increased. Indications for CLKT in children differ from those for adults and typically include rare congenital conditions; subsequently limited numbers of this procedure have been performed in paediatric patients worldwide. Scant literature exists on the subject. Methods. Subsequent to institutional approval, a retrospective chart analysis of all paediatric CLKTs performed at the Transplant Unit, Wits Donald Gordon Medical Centre, University of the Witwatersrand, Johannesburg, South Africa between January 2005 and July 2013 was conducted. Results. Defining children as younger than 18 years of age, 43 patients had received a liver transplant since 2005, of whom 8 received a CLKT. Indications included autosomal recessive polycystic kidney disease (n=3), primary hyperoxaluria type 1 (n=4) and heterozygous factor H deficiency with atypical haemolytic uraemic syndrome (n=1). Graft combinations included whole liver and one kidney (n=5), whole liver and two kidneys (n=1) and left lateral liver segment and one kidney (n=2), all from deceased donors. Patient age ranged from 4 to 17 years (median 9) and included 4 females and 4 males. Weight ranged from 13 to 42 kg (median 22.5). We describe one in-hospital mortality. The remaining 7 patients were long-term survivors with a survival range from 6 to 65 months. Conclusions. Although rarely indicated in children, CLKT is an effective treatment option, appropriately utilising a scarce resource and significantly improving quality of life in the recipient. en_ZA
dc.language.iso en en_ZA
dc.subject.mesh Kidney Transplantation--in infancy & childhood
dc.subject.mesh Liver Transplantation--in infancy & childhood
dc.title Combined paediatric liver-kidney transplantation: analysis of our experience en_ZA
dc.type Thesis en_ZA


Files in this item

This item appears in the following Collection(s)

Show simple item record

Search WIReDSpace


Browse

My Account