The references of the manuscripts were cross-checked to implement further articles into the review. The analyzed parameters include demographic data,

indication for LTx and KTx. duration oil the waiting list, Model for End-Stage Liver Disease (MELD) score, Child-Turcotte-Pugh (CTP) score. immunosuppressive regimen, post-ransplant complications, graft and patient survival. and cause of death. From 1988 to 2009, a total of 22 CLKTx were performed at our institution. The median age of the patients at the time of CLKTx was 44.8 (range: 4.5-58.3 yr). The indications for LTx were liver cirrhosis. hyperoxaluria type 1, polycystic liver disease. primary Or Secondary sclerosing this website cholangitis malignant hepatic epithelioid hemangioendothelioma. cystinosis, and congenital biliary fibrosis. The KTx indications were end-stage renal disease of various causes. hyperoxaluria type 1, polycystic kidney disease, and cystinosis. The mean follow-up duration for CLKTx patients were 4.6 +/- 3.5 yr (range: 0.5-12 yr). Overall, the most important encountered complications were sepsis (n = 8). liver failure leading to retransplantation (n = 4), liver rejection (n = 3). and kidney rejection

(n = 1). The over-all patient survival rate was 80%. Review of the literature showed that from 1984 to 2008. 3536 CLKTx cases were reported. The main indications for CLKTx were oxalosis of both organs, liver Bcr-Abl inhibitor cirrhosis and chronic renal failure, polycystic liver and kidney disease, and livcr cirrhosis along

selleck chemicals with hepatorenal syndrome (HIRS). The most common encountered complications following CLKTx were infection. bleeding, biliary complications. retransplantation of the liver, acute hepatic artery thrombosis, and retransplantation of the kidney. From the available data regarding the need for post-operative dialysis (n = 673) a total of 175 recipients (26%) required hemodiaylsis. During the follow-up period, 154 episodes of liver rejection (4.3%) and 113 episodes of kidney rejection (3.2%) occurred. The cumulative 1, 2. 3, and 5 yr SUrvival of both organs were 78.2%, 74.4%, 62.4%, Lind 60.9%, respectively. Additionally. the cumulative 1, 2, 3. and 5 yr patient survival were 84.9%. 52.8′%. 45.4%, and 42.6%, respectively.

The total number of reported deaths was 181 of 2808 cases (6.4%), from them the cause of death in 99 (55%) cases was sepsis. It can be Concluded that there is still no definitive evidence of better graft and patient survival in CLKTx recipients when compared with LTx alone because of the complexity of the exact definition of irreversible kidney function in LTx candidates. Additionally, CLKTx is better to be performed earlier than isolated LTx and KTx leading to the avoidance of deterioration of clinical Status, high rate of graft loss, and mortality.