Simultaneous Liver-Kidney Transplantation

Abstract

Decompensated liver cirrhosis is a main indication for liver transplantation. Impaired renal function due to liver cirrhosis is observed in approximately 20% of patients during the first year and it reaches 40% by the fifth year.When there is renal damage as a result of glumerulonephritis, diabetes, hepatitis C and need for dialysis, then a combined liver-kidney transplantation could be highly necessary.Out of the 67 liver transplantations performed in University Hospital Lozenets`, there was one patient diagnosed with hepatorenal syndrome. In that case, it was decided that a simultaneous transplantation of two organs should be performed.We present the case of a 21-year-old man with decompensated liver cirrhosis, class C by Child, with a congenital hepatic fibrosis (MELD 28). Chronic tubulointerstitial nephritis and a medullary sponge kidney were observed. Due to acute encephalopathy and deteriorating liver and kidney status, the patient became subject to a simultaneous liver-kidney transplantation with organs from a deceased donor.