肝肾联合移植治疗巨大多囊肾合并多囊肝并发肝肾功能衰竭

Simultaneous liver-kidney transplantation in polycystic kidney and hepatic disease with kidney and liver failure

目的总结巨大多囊肾合并多囊肝并发肝肾功能衰竭行肝肾联合移植的临床经验。方法对8例巨大多囊肾合并多囊肝并发肝肾功能衰竭的患者进行肝肾联合移植，男性5例，女性3例；年龄41～67岁，平均52．8岁。先肝后。肾采用经典非转流原位肝移植6例，先肾后肝并采用背驮式肝移植2例。术后对急性排斥反应、并发症、肝肾功能、人／肝／肾存活率等临床疗效进行长期随访。结果随访28～65个月，8例患者均存活，肝肾功能正常。存活5年以上2例，4年以上2例，2年以上4例。围手术期并发胸腔积液2例，肺部金黄色葡萄球菌感染1例，均对症治疗后痊愈。截至随访终点，未发现移植物急性排斥反应。结论巨大多囊肾合并多囊肝并发肝肾功能衰竭的患者，肝肾联合移植术是安全有效的治疗方法。

Objective To review the clinical experiences concerning simultaneous liver-kidney transplantation in polycystic kidney and hepatic disease with kidney and liver failure. Methods This study involved 8 cases of simultaneous liver-kidney transplantation in polycystie kidney and hepatic disease with kidney and liver failure. There were 5 male and 3 female patients, aged from 41 to 67 years old with a mean of 52. 8 years old. Six cases transplanted kidney after liver with orthotopic liver transplantation, and 2 cases transplanted liver after kidney with piggy-back liver transplantation. The acute rejections, complications, liver function, kidney functions, and survival rates of patient/liver/kidney were recorded. Results Within the follow-up of 28 to 65 months, all 8 patients are still alive with normal liver and kidney functions ： 2 living more than 5 years, 2 living more than 4 years and 4 living more than 2 years. 2 cases of pleural effusion and 1 case of pneumonia were complications after operation, which had been cured successfully. No acute rejection of allograft was observed. Conclusions Simultaneous liver-kidney transplantation is a safe and effective treatment for polycystic kidney and hepatic disease with kidney and liver failure.