First successful case of simultaneous liver and kidney transplantation for patients with chronic liver and renal failure in Japan

Takahito Yagi, Daisuke Nobuoka, Susumu Shinoura, Yuzo Umeda, Daisuke Sato, Ryuichi Yoshida, Masashi Utsumi, Tomokazu Fuji, Hiroshi Sadamori, Toshiyoshi Fujiwara

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Establishment of a preferential liver allocation rule for simultaneous liver and kidney transplantation (SLK) and revisions of laws regarding organ transplants from deceased donors have paved the way for SLK in Japan. Very few cases of SLK have been attempted in Japan, and no such recipients have survived for longer than 40 days. The present report describes a case of a 50-year-old woman who had undergone living donor liver transplantation at the age of 38 years for management of post-partum liver failure. After the first transplant surgery, she developed hepatic vein stenosis and severe hypersplenism requiring splenectomy. She was then initiated on hemodialysis (HD) due to the deterioration of renal function after insertion of a hepatic vein stent. She was listed as a candidate for SLK in 2011 because she required frequent plasma exchange for hepatic coma. When her Model for End-stage Liver Disease score reached 46, the new liver was donated 46 days after registration. The reduced trisegment liver and the kidney grafts were simultaneously transplanted under veno-venous bypass and intraoperative HD. The hepatic artery was reconstructed prior to portal reconstruction in order to shorten anhepatic time. Although she developed subcapsular bleeding caused by hepatic contusion on the next day, subsequent hemostasis was obtained by transcatheter embolization. Thereafter, her recovery was uneventful, except for mild rejection and renal tubular acidosis of the kidney graft. This case highlights the need to establish Japanese criteria for SLK.

Original languageEnglish
Pages (from-to)358-363
Number of pages6
JournalHepatology Research
Volume44
Issue number3
DOIs
Publication statusPublished - 2014

Fingerprint

End Stage Liver Disease
Liver Transplantation
Kidney Transplantation
Chronic Kidney Failure
Japan
Transplants
Hepatic Veins
Liver
Kidney
Renal Dialysis
Hypersplenism
Renal Tubular Acidosis
Plasma Exchange
Hepatic Encephalopathy
Contusions
Living Donors
Hepatic Artery
Liver Failure
Splenectomy
Hemostasis

Keywords

  • Deceased donor
  • Kidney transplantation
  • Liver transplantation
  • Living donor
  • Retransplantation
  • Simultaneous

ASJC Scopus subject areas

  • Hepatology
  • Infectious Diseases

Cite this

First successful case of simultaneous liver and kidney transplantation for patients with chronic liver and renal failure in Japan. / Yagi, Takahito; Nobuoka, Daisuke; Shinoura, Susumu; Umeda, Yuzo; Sato, Daisuke; Yoshida, Ryuichi; Utsumi, Masashi; Fuji, Tomokazu; Sadamori, Hiroshi; Fujiwara, Toshiyoshi.

In: Hepatology Research, Vol. 44, No. 3, 2014, p. 358-363.

Research output: Contribution to journalArticle

@article{59ecc09f184b44b283660f0e0f5cc678,
title = "First successful case of simultaneous liver and kidney transplantation for patients with chronic liver and renal failure in Japan",
abstract = "Establishment of a preferential liver allocation rule for simultaneous liver and kidney transplantation (SLK) and revisions of laws regarding organ transplants from deceased donors have paved the way for SLK in Japan. Very few cases of SLK have been attempted in Japan, and no such recipients have survived for longer than 40 days. The present report describes a case of a 50-year-old woman who had undergone living donor liver transplantation at the age of 38 years for management of post-partum liver failure. After the first transplant surgery, she developed hepatic vein stenosis and severe hypersplenism requiring splenectomy. She was then initiated on hemodialysis (HD) due to the deterioration of renal function after insertion of a hepatic vein stent. She was listed as a candidate for SLK in 2011 because she required frequent plasma exchange for hepatic coma. When her Model for End-stage Liver Disease score reached 46, the new liver was donated 46 days after registration. The reduced trisegment liver and the kidney grafts were simultaneously transplanted under veno-venous bypass and intraoperative HD. The hepatic artery was reconstructed prior to portal reconstruction in order to shorten anhepatic time. Although she developed subcapsular bleeding caused by hepatic contusion on the next day, subsequent hemostasis was obtained by transcatheter embolization. Thereafter, her recovery was uneventful, except for mild rejection and renal tubular acidosis of the kidney graft. This case highlights the need to establish Japanese criteria for SLK.",
keywords = "Deceased donor, Kidney transplantation, Liver transplantation, Living donor, Retransplantation, Simultaneous",
author = "Takahito Yagi and Daisuke Nobuoka and Susumu Shinoura and Yuzo Umeda and Daisuke Sato and Ryuichi Yoshida and Masashi Utsumi and Tomokazu Fuji and Hiroshi Sadamori and Toshiyoshi Fujiwara",
year = "2014",
doi = "10.1111/hepr.12122",
language = "English",
volume = "44",
pages = "358--363",
journal = "Hepatology Research",
issn = "1386-6346",
publisher = "Wiley-Blackwell",
number = "3",

}

TY - JOUR

T1 - First successful case of simultaneous liver and kidney transplantation for patients with chronic liver and renal failure in Japan

AU - Yagi, Takahito

AU - Nobuoka, Daisuke

AU - Shinoura, Susumu

AU - Umeda, Yuzo

AU - Sato, Daisuke

AU - Yoshida, Ryuichi

AU - Utsumi, Masashi

AU - Fuji, Tomokazu

AU - Sadamori, Hiroshi

AU - Fujiwara, Toshiyoshi

PY - 2014

Y1 - 2014

N2 - Establishment of a preferential liver allocation rule for simultaneous liver and kidney transplantation (SLK) and revisions of laws regarding organ transplants from deceased donors have paved the way for SLK in Japan. Very few cases of SLK have been attempted in Japan, and no such recipients have survived for longer than 40 days. The present report describes a case of a 50-year-old woman who had undergone living donor liver transplantation at the age of 38 years for management of post-partum liver failure. After the first transplant surgery, she developed hepatic vein stenosis and severe hypersplenism requiring splenectomy. She was then initiated on hemodialysis (HD) due to the deterioration of renal function after insertion of a hepatic vein stent. She was listed as a candidate for SLK in 2011 because she required frequent plasma exchange for hepatic coma. When her Model for End-stage Liver Disease score reached 46, the new liver was donated 46 days after registration. The reduced trisegment liver and the kidney grafts were simultaneously transplanted under veno-venous bypass and intraoperative HD. The hepatic artery was reconstructed prior to portal reconstruction in order to shorten anhepatic time. Although she developed subcapsular bleeding caused by hepatic contusion on the next day, subsequent hemostasis was obtained by transcatheter embolization. Thereafter, her recovery was uneventful, except for mild rejection and renal tubular acidosis of the kidney graft. This case highlights the need to establish Japanese criteria for SLK.

AB - Establishment of a preferential liver allocation rule for simultaneous liver and kidney transplantation (SLK) and revisions of laws regarding organ transplants from deceased donors have paved the way for SLK in Japan. Very few cases of SLK have been attempted in Japan, and no such recipients have survived for longer than 40 days. The present report describes a case of a 50-year-old woman who had undergone living donor liver transplantation at the age of 38 years for management of post-partum liver failure. After the first transplant surgery, she developed hepatic vein stenosis and severe hypersplenism requiring splenectomy. She was then initiated on hemodialysis (HD) due to the deterioration of renal function after insertion of a hepatic vein stent. She was listed as a candidate for SLK in 2011 because she required frequent plasma exchange for hepatic coma. When her Model for End-stage Liver Disease score reached 46, the new liver was donated 46 days after registration. The reduced trisegment liver and the kidney grafts were simultaneously transplanted under veno-venous bypass and intraoperative HD. The hepatic artery was reconstructed prior to portal reconstruction in order to shorten anhepatic time. Although she developed subcapsular bleeding caused by hepatic contusion on the next day, subsequent hemostasis was obtained by transcatheter embolization. Thereafter, her recovery was uneventful, except for mild rejection and renal tubular acidosis of the kidney graft. This case highlights the need to establish Japanese criteria for SLK.

KW - Deceased donor

KW - Kidney transplantation

KW - Liver transplantation

KW - Living donor

KW - Retransplantation

KW - Simultaneous

UR - http://www.scopus.com/inward/record.url?scp=84895195944&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84895195944&partnerID=8YFLogxK

U2 - 10.1111/hepr.12122

DO - 10.1111/hepr.12122

M3 - Article

VL - 44

SP - 358

EP - 363

JO - Hepatology Research

JF - Hepatology Research

SN - 1386-6346

IS - 3

ER -