Related Experiment Video
Updated: Apr 5, 2026
Robot-Assisted Kidney Transplantation
Published on: July 19, 2021
Pediatric combined liver-kidney transplantation: a 2015 update
Justine Bacchetta1, Djalila Mekahli, Christine Rivet
1aCentre de Référence des Maladies Rénales Rares, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron Cedex bUniversité Lyon 1, Faculté de Médecine Lyon Est, Lyon, France cDepartment of Pediatric Nephrology, University Hospital of Leuven, Leuven, Belgium dService d'Hépato-Gastro-Entérologie et de Nutrition Pédiatrique eChirurgie Pédiatrique, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France.
Insights
Pediatric combined liver-kidney transplantation (CLKT) is feasible for complex diseases, offering long-term outcomes comparable to single organ transplants. Highly trained teams are crucial for managing this challenging procedure in young patients.
Area of Science:
- Pediatric transplantation surgery
- Organ transplantation outcomes
- Nephrology and Hepatology
Background:
- Combined liver-kidney transplantation (CLKT) is a complex procedure with limited pediatric experience.
- Indications for pediatric CLKT include metabolic diseases, autosomal recessive polycystic kidney disease, ciliopathies, and atypical hemolytic uremic syndrome.
Purpose of the Study:
- To provide an updated review of pediatric CLKT as of 2015.
- To summarize current knowledge and outcomes of CLKT in children.
Main Methods:
- Review of existing series and registry studies on pediatric CLKT.
- Analysis of long-term outcomes and feasibility data.
Main Results:
- Pediatric CLKT is feasible, even in very young and small patients.
- Long-term outcomes of CLKT are comparable to isolated liver or kidney transplantation.
- The immediate postoperative period presents significant challenges.
Conclusions:
- While feasible, questions remain regarding the optimal approach (combined vs. sequential) for specific conditions like primary hyperoxaluria and autosomal recessive polycystic kidney disease.
- International collaboration and registries are needed to further advance understanding and management of pediatric CLKT.
Purpose Of Review:
The experience of combined liver-kidney transplantation (CLKT) is limited in pediatric populations. This strategy is, however, required in specific diseases such as metabolic diseases (namely primary hyperoxaluria type one and methylmalonic acidemia), autosomal recessive polycystic kidney disease, miscellaneous ciliopathies and atypical hemolytic uremic syndrome.
Recent Findings:
Different series and registry studies have confirmed the feasibility of pediatric CLKT with encouraging results in the long term, even in the youngest and smallest patients, provided that highly trained multidisciplinary teams are involved in this global management. As such, the long-term outcomes after CLKT are currently comparable to that of isolated liver or kidney transplantations, even though the immediate postoperative period remains challenging.
Summary:
Some questions remain nevertheless unanswered, such as the respective place of combined versus sequential liver-kidney transplantation, especially in primary hyperoxaluria and autosomal recessive polycystic kidney disease. The aim of this review was therefore to provide a 2015 update on pediatric CLKT. In the future, international collaborative studies and registries may help to improve our knowledge of this rare and still highly challenging technique.
Related Concept Videos
01:28Kidney Transplant I: Introduction
01:26Kidney Transplant II: Surgical Procedure
01:16Kidney Transplant III: Nursing Management
01:22Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test