The French journal of urology · 2026
Postoperative follow-up and long-term outcome of combined liver-kidney transplantations.
СтатьяНаблюдательное исследованиеМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Chin A Sen Florence, Lebret Thierry, Soorojebally Yanish, Hertig Alexandre, Gaudez François, Dondero Federica, Neuzillet Yann
Аннотация
INTRODUCTION: The use of combined liver-kidney transplantation (CLKT) in the management of patients with concomitant failure of both organs is becoming increasingly common. However, European data regarding postoperative outcomes and long-term prognosis in adult patients remain limited. This study aimed to describe short- and long-term outcomes after CLKT in a multicentre French cohort.
MATERIAL AND METHODS: We conducted a retrospective observational study including all adult patients who underwent CLKT between January 2010 and December 2024 across three Parisian transplant centers. Data were collected from institutional medical records and the national registry of the Agence de la biomédecine. Variables analyzed included recipient and donor characteristics, perioperative parameters, immunological data, and postoperative outcomes. Survival was estimated using the Kaplan-Meier method.
RESULTS: Forty-one patients were included (median age 53years; 71% male). The main indications were cirrhosis (46%) and polycystic liver-kidney disease (39%). DGF occurred in 42% of patients and was significantly associated with postoperative complications (P=0.012), and long-term dialysis (P<0.01). At 1year, non-preserved renal function (40% of patients) correlated with DGF and early complications. Three patients (7.5%) developed postoperative liver dysfunction, which strongly impacted both patient and graft survival. Overall survival was 87.8% at 6months, 62.1% at 5years, and 23.5% at 10years. Death-censored kidney graft survival reached 78.2% at 5years.
CONCLUSION: CLKT offers satisfactory long-term outcomes in carefully selected adults, despite high early morbidity. Early renal and hepatic dysfunctions are major prognostic factors, highlighting the need for optimized perioperative management and improved patient selection.
MATERIAL AND METHODS: We conducted a retrospective observational study including all adult patients who underwent CLKT between January 2010 and December 2024 across three Parisian transplant centers. Data were collected from institutional medical records and the national registry of the Agence de la biomédecine. Variables analyzed included recipient and donor characteristics, perioperative parameters, immunological data, and postoperative outcomes. Survival was estimated using the Kaplan-Meier method.
RESULTS: Forty-one patients were included (median age 53years; 71% male). The main indications were cirrhosis (46%) and polycystic liver-kidney disease (39%). DGF occurred in 42% of patients and was significantly associated with postoperative complications (P=0.012), and long-term dialysis (P<0.01). At 1year, non-preserved renal function (40% of patients) correlated with DGF and early complications. Three patients (7.5%) developed postoperative liver dysfunction, which strongly impacted both patient and graft survival. Overall survival was 87.8% at 6months, 62.1% at 5years, and 23.5% at 10years. Death-censored kidney graft survival reached 78.2% at 5years.
CONCLUSION: CLKT offers satisfactory long-term outcomes in carefully selected adults, despite high early morbidity. Early renal and hepatic dysfunctions are major prognostic factors, highlighting the need for optimized perioperative management and improved patient selection.