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Combined liver and kidney transplantation in children.
[primary hyperoxaluria type 1]
Simultaneous
combined
liver
-kidney
transplantation
(
CLKT
)
is
a
rare
operation
in
pediatric
patients
so
that
annually
only
10
-
30
operations
are
performed
worldwide
.
The
main
indications
for
CLKT
are
primary
hyperoxaluria
type
1
and
autosomal
recessive
polycystic
kidney
disease
.
In
addition
,
CLKT
is
indicated
in
individual
patients
with
metabolic
or
cirrhotic
liver
diseases
and
end-
stage
kidney
disease
.
The
surgery
and
immediate
post-operative
management
of
CLKT
remain
challenging
in
infants
and
small
children
.
The
patients
should
be
operated
on
before
they
become
severely
ill
or
develop
major
systemic
manifestations
of
their
metabolic
disorder
.
The
liver
allograft
is
immunologically
protective
of
the
kidney
graft
in
simultaneous
CLKT
,
often
resulting
in
well-preserved
kidney
function
.
The
long
-term
outcome
after
CLKT
is
nowadays
comparable
to
that
of
isolated
liver
and
kidney
transplantations
.
Diseases
Validation
Diseases presenting
"liver-kidney transplantation"
symptom
primary hyperoxaluria type 1
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