COMBINED LIVER AND KIDNEY-TRANSPLANTATION

Patients with end-stage renal and hepatic failure may be treated with combined liver and kidney transplantation (CLKTx). We reviewed the ind ications and outcomes of 16 CLKTx performed at the University of Minne sota between 1980 and 1994. The majority of the recipients (87.5 %) we re young patients affected by congenital hepatic anomalies and concomi tant end-stage renal failure. Fourteen were treated with cyclosporin-b ased immunosuppression and had an excellent outcome: with an average o f 6 years of follow-up, patient survival was 85.7 %, liver graft survi val 85.7 %, and kidney graft survival 72 %. The incidence of rejection episodes was similar to the rate of rejection in our solitary kidney and liver transplants. In conclusion, our experience supports the valu e of CLKTx in treating patients with simultaneous failure of both orga ns or with congenital enzymatic hepatic deficits leading to renal fail ure.