Combined liver-kidney transplantation and orthotopic liver transplantation in the treatment of severe hepatitis B

/Qi Xiaosheng

(戚曉升，Dept Gen Surg，Shanghai 1st Peop Hosp，Shanghai 200080)…∥Chin J Gen Surg.-2011，26(10).-804～806

ObjectiveTo compare orthotopic liver transplantation(OLT)and combined liver-kidney transplantation(CLKT)in the treatment of severe hepatitis.MethodsIn this study 52 patients of severe hepatitis B were allocated to OLT(40 cases)or CLKT(12 csaes)at our deparment from Jan.2001 to Sep.2005.ResultsThe preoperative renal functions in CLKT cases were poorer than that in OLT cases，Postoperative severe infection was more common in CLKT cases than that in OLT cases.In OLT group 28 patients(70%)suffered from early posttransplant renal dysfunction，among them 11 patients needed dialysis，whilst there were 2(16.7%)patients who needed dialysis in CLKT group(p ＜ 0.01).The posttransplant mortality in OLT group was 40%(n=16)，significantly higher than that in CLKT(16.7%，N=2)(P ＜0.01).In OLT group，9 cases developed severe renal failure and died.None died of renal failure in CLKT group.ConclusionThe prognosis is more favorable to perform CLKT in patients who suffered from severe hepstitis B with chronic renal dysfunction before transplantion.7 refs，2 tabs