Need and timing of kidney transplantation in relation to liver transplantation in polycystic liver disease

Temmerman, Frederik J;Darius, Tom;Pirenne, Jacques;Monbaliu, Diethard;Nevens, Frederik;et.al.
(2011) 62nd Annual Meeting of the American Association for the Study of Liver Diseases: The Liver Meeting 2011 — Location: San Francisco, CA, United States (4.November.2011)

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Authors
  • Temmerman, Frederik J
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  • Darius, Tomorcid-logoUCLouvain
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  • Pirenne, Jacques
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  • Monbaliu, Diethard
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  • Nevens, Frederik
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Abstract
Background: The most common complication of polycystic liver diseases (PCLD) is extensive hepatomegaly which may lead to invalidating abdominal symptoms. In case of ADPKD (autosomal dominant polycystic kidney disease), renal failure develops in 50% of the affected patients. Liver (LT) and/or kidney transplantation (KT) are the only curative therapeutic options for some of these patients. Aim: To study the need and the timing of KT in relation to LT in patients with PCLD. Methods: The outcome of patients who underwent a LT for PCLD between 1995 and 2011 in our tertiary referral center was studied. Results: Study population, 48 patients: 44 ADPKD (92%) and 4 ADPLD (8%) (autosomal dominant polycystic liver disease). In the ADPKD subgroup there were 36 women (82%) and 8 men (18%); in the ADPLD group all patients were women. In the ADPKD subgroup, 31 patients (70.5%) developed renal failure and underwent a KT at some time in their disease process: 18 patients (58%) received immediately a combined LT+KT (the indication for combined KT in case of LT was a clearance of < 30ml/min) (group A). 7 patients (23%) first received a KT and received then a combined LT+KT or a LT (group B); 6 patients (19%) first received a LT and subsequently a KT (group C). None of the ADPLD patients required a KT (group D). Detailed analysis of the different groups are given in the table. The 5 years liver graft and patient survival of LT was 91.6%. The 5 year graft and patient survival of combined LT+KT was 80%. Conclusion Post-transplant survival rates in PCLD are excellent. 70.5% of ADPKD patients, who received a LT, need a KT at some point during their disease process. After a KT, a LT was needed in 16% on average after 15 years; and this occurred especially in men and mostly because of liver volume related problems and recurrent liver cysts infections. After a LT, in 14% of the patients, especially women, a KT was needed on average after 8 years. Finally, combined LT+KT was necessary in 41% of the ADPKD patients (Table Presented).
Affiliations
  • University Hospitals, Leuven, BelgiumAbdominal Transplant Surgery

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Temmerman, F. J., Darius, T., Pirenne, J., Monbaliu, D., Aerts, R., Bammens, B., Laleman, W., Cassiman, D., Verslype, C., Van Steenbergen, W., Kuypers, D., & Nevens, F. (2011). Need and timing of kidney transplantation in relation to liver transplantation in polycystic liver disease. Hepatology, 54(Suppl1), 650A. https://doi.org/10.1002/hep.24666 (Original work published 2011)