Introduction: In some diseases characterized by metabolic disorders in the liver, certain substances accumulated in the body can damage the kidney and cause chronic renal failure. In addition, some genetic diseases such as polycystic kidney disease may be accompanied by liver failure. In such cases, the patient needs both liver and kidney transplantation. Dual organ transplants are a more complex procedure than single organ transplants and have higher morbidity and mortality. In this study, we evaluated the outcomes of patients who underwent liver and kidney transplantation.
Materials and methods: In our center, 776 liver transplants were performed between 1988 and 2025, and 3630 kidney transplants were performed between 1975 and 2025. There were 12 patients who underwent liver and kidney transplantation. The average age was 17 years old. Four of our patients were male and 8 were female. One patient underwent simultaneous cadaveric liver and kidney transplantation, and one patient underwent cadaveric kidney and living donor liver transplantation at different times. All other patients underwent transplantation at different times (combined) from living donors. The most common etiology was primary hyperoxaluria. Other causes were Caroli, congenital hepatic fibrosis, cryptogenic cirrhosis and progressive familial intrahepatic cholestasis for the liver, polycystic kidney disease, hepatorenal syndrome and focal segmentary glomerulosclerosis for the kidney.
Results: The mean follow-up period of the patients was 5.6 years. A patient who underwent simultaneous cadaveric kidney and liver transplantation due to primary hyperoxaluria started dialysis again due to humoral rejection and widespread oxalate accumulation in the early period. Two patient who underwent combined liver and kidney transplantation due to primary hyperoxaluria had normal creatinine levels in the early period but had an accelerated rejection attack in the first week and was rejected. Graft nephrectomy was performed. The other patients continue their long-term follow-up with completely normal liver and kidney functions.
Conclusion: The timing of organ transplants should be carefully planned in patients who develop liver and renal failure and should be closely monitored for rejection and graft failure in the early postoperative period.