Two cases of combined liver-kidney transplantation

Objectives To report the clinical experiences of simultaneous hepatorenal t ransplantation. Methods We performed simultaneous hepatorenal transplantation in one patien t with liver cirrhosis of hepatitis B and uremia of chronic nephritis on Fe bruary 1, 1999 and one patient with liver cirrhosis of hepatitis B complica ted by hepatorenal syndrome on March 12, 1999. The donors were heart arrest cases. Rapid multiple organ harvesting techniques and UW solution infusion in situ were used. Liver and kidney transplantation were orthotopic and or dinary methods, respectively. Immunosuppressive drugs consisted of cyclospo rine, Cellcept, ALG and cortstco steroids. Lamividine was used on day 50 an d day 40 postoperation, respectively. Results Both transplanted organs rapidly achieved normal function postopera tion and the patients recovered well but suffered mild kidney rejection day 110 postoperation in No 1 patient. In No 2 patient, acute renal function f ailure, mental symptoms, muscle spasm, cerebral artery thrombosis, inhalati on pneumonia and chronic liver graft rejection ensured sequentially but wer e controlled. The patients have survived for more than nine and eight month s, respectively, with normal life quality. Conclusions Combined hepatorenal transplant is a radical treatment method f or liver and kidney function failure and requires more comprehensive techni ques than isolated single organ transplantation. Preventing the recurrence of hepatitis B by oral lamividine may be a key to long-term survival.