The Long-term Outcomes Of Patients With Hepatitis B Undergoing Simultaneous Liver-kidney Transplantation

Backgroud:The number and long-term survival of simultaneous liver-kidney transplantation (SLK) has increased since implementation of Model for End-Stage Liver Disease (MELD) scoring system. However, data on short-term and long-term outcomes of HBV+SLK have not been reported.Methods:A total of68cases including21cases of HBV+SLK patients performed at our transplant center from January2001to May2005compared with22cases of HBV positive kidney transplant alone (KTA) and25cases of pre-liver transplant renal dysfunction (HBV+) performed during that period. Plasma MBL concentrations was detected in the blood of transplantation recipients between CMV infection recipients and non-infection recipients.Results:There were increased early post-transplant infection episodes in SLK (38.1%) versus LTA (20%)(p=0.175) and incresed ICU time (P=0.005). The1-,3-,5-year overall survival rates for the SLK groups were90.5%,81.0%,81.0%. There were difference of1-year survival between two groups (p=0.036). SLK recipients HBV recurrence rate higher than LTA (38.1%vs4%p=0.007). There were no significant difference of1-,3-,5-year overall survival rates between SLK recipients and KTA. The incidence of acute kidney rejection was significanta difference (0%vs40.9%, p=0.001). Multivariate regression analysis showed that post-operative renal failure is Significant independent risk factors for death of LTA (OR48, p=0.003). Upon logistic regression analysis, Plasma MBL concentrations (500ng/mL) was the independent risk factors to develop CMV infection.Conclusion:Our study was the first and largest analysis of HBV+SLK outcomes to date. The study demonstrate increased early post-transplant infection episodes, ICU time in SLK versus LTA, however1-year survival rates of SLK recipients higher than LTA. HBV recurrence after SLK was higer than LTA, but through rational treatment does not affect the long-term survival.