Spanish 
Chinese 
Russian 
German 
French 
Japanese 
Portuguese 
Hindi Case Report
The First Case Series of Combined Liver-Kidney Transplantation (CLKT) from Thailand
Abhasnee Sobhonslidsuk1*, Surasak Leelaudomlipi1, Pongphob Intaraprasong2, Sasinee Tongprasert2, Piyaporn Kaewdoung3, Supanna Petraksa3, Piyanut Pootracool4, Somchai Viengteerawat4, Pattana Sornmayura5, Napat Angkathunyakul5, Suthus Sriphojanart6 and Vasant Sumethkul6
1Division of Gastroenterology and Hepatology, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
2Division of Nephrology, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
3Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
4Department of Surgery, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
5Department of Anesthesiology, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
6Department of Pathology, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
- *Corresponding Author:
- Abhasnee Sobhonslidsuk
Division of Gastroenterology and Hepatology
Department of Medicine, Ramathibodi Hospital 270 Praram 6 road
Rajathevee Bangkok 10400, Thailand
Tel: 662-201-1304, 662-201 1304
E-mail: teasb@hotmail.com
Received date: October 23, 2014; Accepted date: December 03, 2014; Published date: December 08, 2014
Citation: Sobhonslidsuk A, Leelaudomlipi S, Intaraprasong P, Tongprasert S, Kaewdoung P, et al. (2014) The First Case Series of Combined Liver-Kidney Transplantation (CLKT) from Thailand. J Gastrointest Dig Syst 4:246. doi:10.4172/2161-069X.1000246
Copyright: © 2014 Sobhonslidsuk A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
From the hospital database, four patients underwent CLKT. Three patients had ESRD and cirrhosis. Causes of cirrhosis were chronic hepatitis B and chronic hepatitis C in two and one patient. The fourth patient underwent CLKT due to subfulminant liver failure and prolonged acute renal failure with severely damaged kidney and required hemodialysis for 5 weeks. The waiting time ranged from 6 to 1988 days. After CLKT, one patient required hemodialysis for 45 days because of prolonged acute tubular necrosis. Mild early liver graft dysfunction occurred in one patient. Induction regimens were IL2-receptor blockers, steroids and tacrolimus in three patients, and steroids combining with tacrolimus in one patient. Maintenance regimens included tacrolimus, mycophenolate mofetil (with or without low-dose prednisolone). One-year graft and patient survival rate was 100%. Median follow-up time was 2.2 years. None developed liver or renal graft rejection. At 6 and 12 months, median creatinine levels were 1.30 and 1.13 mg/dl. At the last visits, median creatinine level was 1.05 mg/dl with median eGFR of 76.45 ml/min. CLKT may be done in the patients with ESRD and viral hepatitis-related cirrhosis even without portal hypertension. Other indication is for patients with acute liver failure with severely damaged ARF.
