Long-term outcome of combined liver-kidney transplantation: a single-center experience in China

To evaluate patient survival with combined liver-kidney transplantation (CLKT) and to identify factors of death in these patients.

Among 554 cases of liver transplantations (LTs) performed between January 1999 and October 2006, there were 19 cases (3.43%) of CLKT recipients. To compare the patient survival, 50 matched LT patients out of these patients were analyzed retrospectively. Furthermore, causes of death in CLKT patients were investigated.

Within a mean follow-up of 25.2 months (range 1-96 months), 7 CLKT patients had died (mortality: 36.8%). There were 4 (21.1%) that died in hospital within 1 month, and 3 late mortality cases (deceased after hospital discharge). Actuarial survival was 73.7% at 1 year, 59.5% at 3 years, and 59.5% at 5 years. Cumulative patient survival was significantly worse among CLKT patients compared with LT patients. After excluding patients who died during the first month in the 2 groups, cumulative patient survivals were comparable between the 2 groups. The survival rate in CLKT patients was 87.5% at 1 year, 70.7% at 3 years, and 70.7% at 5 years.

CLKT has relatively high hospital mortality as compared to LT. Beyond the hospital discharge, however, the long-term survival does not differ from LT.