P.302 Long-term outcome after pediatric combined liver and kidney transplantation: A CERTAIN registry analysis
Monday May 06, 2019 from 17:00 to 18:00
Exhibit-Poster Area
Presenter

Florian Brinkert, Germany

Consultant Hepatologist

Pediatric Gastroenterology and Hepatology

University Medical Center Hamburg-Eppendorf

Abstract

Long-term outcome after pediatric combined liver and kidney transplantation: A CERTAIN registry analysis

Florian Brinkert1, Katja Gorontzi1, Anja K. Büscher2, Peter F. Hoyer2, Lars Pape3, Burkhard Tönshoff4, Markus J. Kemper5, Jun Oh6.

1Pediatric Gastroenterology and Hepatology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; 2Department of Pediatrics, University Hospital Essen, Essen, Germany; 3Department of Pediatrics, University Hospital Hannover, Hannover, Germany; 4Department of Pediatrics, University Children´s Hospital Heidelberg, Heidelberg, Germany; 5Department of Pediatrics, Asklepios Hospital Nord-Heidberg, Hamburg, Germany; 6Pediatric Nephrology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

Introduction: Isolated liver transplantation (LTx) and/or isolated kidney transplantation (KTx) in both paediatric and adult populations can be thought of as routine clinical practice.However, combined liver and kidney transplantation (CLKT) in the paediatric population remains only possible in specialised centers where a highly trained multidisciplinary team is available. The diagnoses leading to this challenging procedure are often rare metabolic diseases leading to chronic kidney disease, including primary hyperoxaluria type 1 (PH1), or diseases causing both renal and liver failure such as autosomal recessive polycystic kidney disease (ARPKD). To date, the available scientific literature mostly consists of single-center analyses. Thus, we aim for a CERTAIN registry analysis to include a larger cohort of patients to better carve out answers as optimal timing of transplantation, decision making between combined transplantation and sequential operation with first liver, then kidney transplantation, optimal perioperative management with the use of renal replacement therapy or the choice of immunosuppressive therapy.  

Methods: We initiated a multicenter retrospective CERTAIN registry analysis. The aim of the study is to include approximately 150 patients. The already documented kidney data set has been added with a specific CLKT data set to assess the liver graft outcome, metabolic profile over time, extra-renal complications and morbidity (cardiac function, fractures, ocular pathologies), longitudinal growth and in ARPKD patients to assess the indication for CLKT.

Results: The transplantation centers of Praque, Rome, Padua, Warsaw, Lyon, Paris, Manchester, London, Dublin, Essen, Hannover, Heidelberg, Tübingen, Turin, Adana, Amsterdam and Hamburg have declared that they will share their data. This would already include 130 patients who underwent a liver and kidney transplantation. Preliminary data will be presented.

Conclusion: The CERTAIN registry analysis gives the opportunity to analyse the largest cohort of pediatric patients undergoing liver and kidney transplantation. We invite all other centers who care for these patients to share their data using the CERTAIN registry.


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