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 personality factor: How to foster the sharing of research data
06.09.2017 | ZBW – Leibniz-Informationszentrum Wirtschaft
Europe’s Demographic Future. Where the Regions Are Heading after a Decade of Crises
10.08.2017 | Berlin-Institut für Bevölkerung und Entwicklung
Our brains house extremely complex neuronal circuits, whose detailed structures are still largely unknown. This is especially true for the so-called cerebral cortex of mammals, where among other things vision, thoughts or spatial orientation are being computed. Here the rules by which nerve cells are connected to each other are only partly understood. A team of scientists around Moritz Helmstaedter at the Frankfiurt Max Planck Institute for Brain Research and Helene Schmidt (Humboldt University in Berlin) have now discovered a surprisingly precise nerve cell connectivity pattern in the part of the cerebral cortex that is responsible for orienting the individual animal or human in space.
The researchers report online in Nature (Schmidt et al., 2017. Axonal synapse sorting in medial entorhinal cortex, DOI: 10.1038/nature24005) that synapses in...
Whispering gallery mode (WGM) resonators are used to make tiny micro-lasers, sensors, switches, routers and other devices. These tiny structures rely on a...
Using ultrafast flashes of laser and x-ray radiation, scientists at the Max Planck Institute of Quantum Optics (Garching, Germany) took snapshots of the briefest electron motion inside a solid material to date. The electron motion lasted only 750 billionths of the billionth of a second before it fainted, setting a new record of human capability to capture ultrafast processes inside solids!
When x-rays shine onto solid materials or large molecules, an electron is pushed away from its original place near the nucleus of the atom, leaving a hole...
For the first time, physicists have successfully imaged spiral magnetic ordering in a multiferroic material. These materials are considered highly promising candidates for future data storage media. The researchers were able to prove their findings using unique quantum sensors that were developed at Basel University and that can analyze electromagnetic fields on the nanometer scale. The results – obtained by scientists from the University of Basel’s Department of Physics, the Swiss Nanoscience Institute, the University of Montpellier and several laboratories from University Paris-Saclay – were recently published in the journal Nature.
Multiferroics are materials that simultaneously react to electric and magnetic fields. These two properties are rarely found together, and their combined...
MBM ScienceBridge GmbH successfully negotiated a license agreement between University Medical Center Göttingen (UMG) and the biotech company Tissue Systems Holding GmbH about commercial use of a multi-well tissue plate for automated and reliable tissue engineering & drug testing.
MBM ScienceBridge GmbH successfully negotiated a license agreement between University Medical Center Göttingen (UMG) and the biotech company Tissue Systems...
19.09.2017 | Event News
12.09.2017 | Event News
06.09.2017 | Event News
21.09.2017 | Physics and Astronomy
21.09.2017 | Life Sciences
21.09.2017 | Health and Medicine