New UCLA research shows that combined liver-kidney transplants appear to benefit patients with diseases in both organs, including patients with potentially reversible kidney failure who have been receiving dialysis for longer than two months. The Archives of Surgery will publish the findings in its August issue.
"Our study indicates that a combined liver-kidney transplant is the procedure of choice for patients suffering end-stage disease in both the liver and kidneys," explained Dr. Ronald Busuttil, professor and chair of surgery at the David Geffen School of Medicine at UCLA. "For the first time, it also appears that a dual-organ transplant can help liver-disease patients with temporary kidney dysfunction."
Hepatorenal syndrome -- potentially reversible kidney failure caused by cirrhosis or another liver disease -- is often treated by liver transplant alone, not a combined procedure. As waiting times for organs rise, however, hepatorenal-syndrome patients face an increased risk of developing a chronic, irreversible condition that may require a combination transplant.
Busuttil and his colleagues reviewed data from 98 patients who underwent 99 combined liver-kidney transplants at the Dumont-UCLA Transplant Center in the Pfleger Liver Institute from 1988 to 2004. The patients' average age was 46 years; 76 suffered from primary kidney diseases and 22 had hepatorenal syndrome.
For comparison, the researchers also reviewed data from 148 patients with hepatorenal syndrome who underwent only a liver transplant between 1998 and 2002, and 743 patients who received only a kidney transplant.
Of the 99 combined-transplant patients, 31 had died. The survival rates at one, three and five years after surgery were 76, 72 and 70 percent, respectively. None of the risk factors analyzed by the UCLA team, including donor characteristics, recipient age or previous transplants, influenced the patient's survival rate after surgery.
A review of organ survival rates in combination-transplant patients showed that 70 percent of the transplanted livers and 76 percent of the transplanted kidneys survived after one year. After three years, 65 percent of the livers and 72 percent of the kidneys survived; and after five years, 65 percent of the livers and 70 percent of the kidneys survived.
Among those who underwent only kidney transplants, 23 percent of the kidneys were rejected by the recipient's body after one year, compared with 14 percent of those who had liver-kidney transplants.
In hepatorenal syndrome patients, those undergoing dialysis -- the use of a machine to perform the blood filtration normally handled by the kidneys -- for longer than two months before surgery recovered better after the combined transplant than patients who received only liver transplants.
"We used to recommend combined liver-kidney transplantation when patients received dialysis for longer than one month before transplantation," said Busuttil. "Based on our current findings, however, we found that the acuteness of renal failure subsided after two months of dialysis. A combined transplant after this time will improve patient survival and also reduce hospital expenditures for patient care.
"Our evaluation shows that combined kidney-liver transplantation performed at a high-volume academic transplant center offers the best option for patients with simultaneous chronic liver and kidney failure," he concluded.
Elaine Schmidt | EurekAlert!
The importance of biodiversity in forests could increase due to climate change
17.11.2017 | Deutsches Zentrum für integrative Biodiversitätsforschung (iDiv) Halle-Jena-Leipzig
Win-win strategies for climate and food security
02.10.2017 | International Institute for Applied Systems Analysis (IIASA)
Heat from the friction of rocks caused by tidal forces could be the “engine” for the hydrothermal activity on Saturn's moon Enceladus. This presupposes that...
The WHO reports an estimated 429,000 malaria deaths each year. The disease mostly affects tropical and subtropical regions and in particular the African continent. The Fraunhofer Institute for Silicate Research ISC teamed up with the Fraunhofer Institute for Molecular Biology and Applied Ecology IME and the Institute of Tropical Medicine at the University of Tübingen for a new test method to detect malaria parasites in blood. The idea of the research project “NanoFRET” is to develop a highly sensitive and reliable rapid diagnostic test so that patient treatment can begin as early as possible.
Malaria is caused by parasites transmitted by mosquito bite. The most dangerous form of malaria is malaria tropica. Left untreated, it is fatal in most cases....
The formation of stars in distant galaxies is still largely unexplored. For the first time, astron-omers at the University of Geneva have now been able to closely observe a star system six billion light-years away. In doing so, they are confirming earlier simulations made by the University of Zurich. One special effect is made possible by the multiple reflections of images that run through the cosmos like a snake.
Today, astronomers have a pretty accurate idea of how stars were formed in the recent cosmic past. But do these laws also apply to older galaxies? For around a...
Just because someone is smart and well-motivated doesn't mean he or she can learn the visual skills needed to excel at tasks like matching fingerprints, interpreting medical X-rays, keeping track of aircraft on radar displays or forensic face matching.
That is the implication of a new study which shows for the first time that there is a broad range of differences in people's visual ability and that these...
Computer Tomography (CT) is a standard procedure in hospitals, but so far, the technology has not been suitable for imaging extremely small objects. In PNAS, a team from the Technical University of Munich (TUM) describes a Nano-CT device that creates three-dimensional x-ray images at resolutions up to 100 nanometers. The first test application: Together with colleagues from the University of Kassel and Helmholtz-Zentrum Geesthacht the researchers analyzed the locomotory system of a velvet worm.
During a CT analysis, the object under investigation is x-rayed and a detector measures the respective amount of radiation absorbed from various angles....
15.11.2017 | Event News
15.11.2017 | Event News
30.10.2017 | Event News
23.11.2017 | Information Technology
23.11.2017 | Physics and Astronomy
23.11.2017 | Life Sciences