Two Cases of Combined Transplantation of Liver and Kidney from Two Living Donors / 대한이식학회지

ABSTRACT

Combined liver-kidney transplantation has gained increasing popularity and applied for the patient with end-stage liver and kidney disease. There are some controversies about the sequence of transplantation. In general, the liver allograft is temporary placed before the kidney allograft. This method may provide some immunologic advantages that liver allograft may protect concomitantly transplantated kidney from rejection. In our opinion, kidney-liver sequence may provide several benefits in hemodynamic stability, safer monitoring and planned fluid replacement by urine flow assessment. Combined liver-kidney transplantation requires only conventional immunosuppressive drug dosage as in kidney transplantation alone. And combined liver-kidney transplantation can be performed with acceptable morbidity and mortality, and have exellent long term result. We present two cases of combined liver-kidney transplantation performed by kidney- liver sequence for complex end organ failure.