Advanced chronic renal failure has been thought of as a contraindication to liver transplantation. We present here seven cases of simultaneous kidney-liver transplant performed for combined end-organ failure. Six of the seven patients are alive with functioning grafts with follow-up of from 6 weeks to 32 months. In one case, the patient chronically rejected his liver graft (treated with successful retransplant) while maintaining good function in his kidney. The rate of acute rejection in the liver transplant was only 37.5% compared with 59.3% in the patients undergoing liver transplant only. There were no obvious rejections observed in the kidney transplants. These cases demonstrate the utility of simultaneous kidney-liver transplant in patients with combined kidney and liver failure. Advanced chronic renal failure should no longer be considered a contraindication to liver transplantation.
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