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《Practical Journal of Medicine & Pharmacy》 2010-01
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Relevent issues and management strategy of combined liver-kidney transplantation:A report of two cases

QV Ming,WANG Ying,SHI Yan-fen,et al.Department of Hepatobiliary Surgery of PLA No.107 Hospital,Yantai,Shandong 264002,China  
Objective To investigate the relevent issues and management strategis of combined liver-kidney transplantation(CKLT).Method Simultaneous liver-kidney transplantation was performed in two patients among whom one patient with chronic kidney failure complicated with liver cirrhosis after hepatitis B(case 1),another with liver cirrhosis after hepatitis B complicated with hepatic carcinoma and urenia due to chronic nephritis(case 2).Donors'organs were infused in situ with UW solution and rapidly harvested.Othotopic liver transplantation was carried out and the kidney was transpalnted with conventional method respectively.Veno-venous bypass and continuous renal replacement therapy(CRRT)was used in the first patient's(case 1)operation.Immunosuppressive therapy included tacrolimus/mycophnolate mofeil/steroid for maintenance.Result Operations were successful in all two cases.Transplanted organs of case 1 rapidly functioneod well after the operation.Delayed graft function recovery(DGF)occurred in case 2.Serum creatine became normal gradually when surpported CRRT was used.Conclusion Combined liver-kidney transplantation is an effective treatment strategy for end-stage liver and kidney disease.Skillful operative technique,comprehensive perioperative monitoring and immediate management of complications are crucial for successful CLKT.
【CateGory Index】: R657.3;R699.2
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