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Simultaneous liver-kidney transplantation: A single-center experience in Korea

Annals of Hepato-Biliary-Pancreatic Surgery 2020년 24권 4호 p.454 ~ 459
김민재, 황신, 안철수, 문덕복, 하태용, 송기원, 정동환, 신성, 김영훈, 하희선, 홍정자, 김인옥, 한덕종, 이승규,
소속 상세정보
김민재 ( Kim Min-Jae ) - University of Ulsan College of Medicine Asan Medical Center Department of Surgery
황신 ( Hwang Shin ) - University of Ulsan College of Medicine Asan Medical Center Department of Surgery
안철수 ( Ahn Chul-Soo ) - University of Ulsan College of Medicine Asan Medical Center Department of Surgery
문덕복 ( Moon Deok-Bog ) - University of Ulsan College of Medicine Asan Medical Center Department of Surgery
하태용 ( Ha Tae-Yong ) - University of Ulsan College of Medicine Asan Medical Center Department of Surgery
송기원 ( Song Gi-Won ) - University of Ulsan College of Medicine Asan Medical Center Department of Surgery
정동환 ( Jung Dong-Hwan ) - University of Ulsan College of Medicine Asan Medical Center Department of Surgery
신성 ( Shin Sung ) - University of Ulsan College of Medicine Asan Medical Center Department of Surgery
김영훈 ( Kim Young-Hoon ) - University of Ulsan College of Medicine Asan Medical Center Department of Surgery
하희선 ( Ha Hea-Seon ) - Asan Medical Center Organ Transplantation Center
홍정자 ( Hong Jung-Ja ) - Asan Medical Center Organ Transplantation Center
김인옥 ( Kim In-Ok ) - Asan Medical Center Organ Transplantation Center
한덕종 ( Han Duck-Jong ) - University of Ulsan College of Medicine Asan Medical Center Department of Surgery
이승규 ( Lee Sung-Gyu ) - University of Ulsan College of Medicine Asan Medical Center Department of Surgery

Abstract


Backgrounds/Aims: Simultaneous liver and kidney transplantation (SLKT) has been established as the treatment of choice for patients with concurrent end?stage liver and end?stage kidney diseases. The objective of this study was to analyze the nationwide incidence of SLKT in Korea and the outcomes of SLKT in a high-volume transplant center.

Methods: Databases of the Korean Network for Organ Sharing (KONOS) and Asan Medical Center from 2000 to 2019 were retrospectively reviewed to determine the incidence of SLKT.

Results: During 20 years from 2000 to 2019, deceased donor SLKT was performed for 38 cases in the KONOS database. The proportion of deceased donor SLKT was 0.6% (20 of 3333) before adoption of MELD score, which was significantly increased to 1.2% (18 of 1524) after the adoption of MELD score (p=0.034). In our institution, there were 11 cases of SLKT (2 cases with deceased donors and 9 cases with living donors). SLKT accounted for 0.2% (11 of 6468) of total liver transplantation volume. During follow-up, five patients died due to hepatocellular carcinoma recurrence (n=2), infection (n=2), or unknown cause (n=1). The 1-year and 10-year overall patient survival rates were 90.9% and 81.8%, respectively.

Conclusions: Results of this study revealed that the incidence of deceased donor SLKT was very low. An increase of such incidence is not anticipated unless the number of deceased donors is markedly increased. Currently, sequential living donor liver transplantation and kidney transplantation with deceased or living donors are mainstays of transplantation rather than SLKT in our institution.

키워드

Hepatocellular carcinoma; Donor shortage; Chronic renal failure; Acute kidney injury; Living donor

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