Combined en bloc liver-double kidney transplantation in an infant with IVC thrombosis

Margaret M. McGuire, Brian A. Jones, Melissa A. Hull, Meghna V. Misra, Charles J. Smithers, Neil R. Feins, Roger L. Jenkins, Craig W. Lillehei, William E. Harmon, Maureen M. Jonas, Heung B. Kim

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

We report a case of a pediatric en bloc liver-double kidney transplant in a patient with IVC thrombosis below the renal veins. The patient is an 11-month-old girl diagnosed with congenital nephrotic syndrome at two months of age. Multifocal liver masses were identified on routine ultrasound at eight months of age. Alpha fetoprotein level was 55 319. Biopsy confirmed hepatoblastoma. CT scan confirmed multiple lesions in both lobes, which would require liver transplantation for resection. She was also found to have thrombosis of her infrarenal IVC secondary to multiple central lines. She was listed for combined liver-kidney transplant and began chemotherapy. After four cycles of chemotherapy, she underwent bilateral nephrectomies followed by a combined en bloc liver-double kidney transplant from a size matched donor. In order to provide adequate venous outflow from the kidneys in the absence of a recipient infrarenal IVC, the donor liver and kidneys were procured en bloc with a common arterial inflow via the infrarenal aorta and common outflow via the suprahepatic IVC. Kidney transplantation in the absence of adequate recipient venous drainage may require unusual vascular reconstruction techniques. This case demonstrates a novel approach in patients who may require combined liver-kidney transplantation.

Original languageEnglish (US)
Pages (from-to)E142-E144
JournalPediatric Transplantation
Volume15
Issue number7
DOIs
StatePublished - Nov 1 2011

Fingerprint

Kidney Transplantation
Thrombosis
Kidney
Liver
Transplants
Liver Transplantation
Tissue Donors
Hepatoblastoma
Drug Therapy
Renal Veins
alpha-Fetoproteins
Nephrotic Syndrome
Nephrectomy
Blood Vessels
Aorta
Drainage
Pediatrics
Biopsy

Keywords

  • hepatoblastoma
  • inferior vena cava thrombosis
  • pediatric kidney transplantation
  • pediatric liver transplantation
  • surgery

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Transplantation

Cite this

McGuire, M. M., Jones, B. A., Hull, M. A., Misra, M. V., Smithers, C. J., Feins, N. R., ... Kim, H. B. (2011). Combined en bloc liver-double kidney transplantation in an infant with IVC thrombosis. Pediatric Transplantation, 15(7), E142-E144. https://doi.org/10.1111/j.1399-3046.2010.01328.x

Combined en bloc liver-double kidney transplantation in an infant with IVC thrombosis. / McGuire, Margaret M.; Jones, Brian A.; Hull, Melissa A.; Misra, Meghna V.; Smithers, Charles J.; Feins, Neil R.; Jenkins, Roger L.; Lillehei, Craig W.; Harmon, William E.; Jonas, Maureen M.; Kim, Heung B.

In: Pediatric Transplantation, Vol. 15, No. 7, 01.11.2011, p. E142-E144.

Research output: Contribution to journalArticle

McGuire, MM, Jones, BA, Hull, MA, Misra, MV, Smithers, CJ, Feins, NR, Jenkins, RL, Lillehei, CW, Harmon, WE, Jonas, MM & Kim, HB 2011, 'Combined en bloc liver-double kidney transplantation in an infant with IVC thrombosis', Pediatric Transplantation, vol. 15, no. 7, pp. E142-E144. https://doi.org/10.1111/j.1399-3046.2010.01328.x
McGuire, Margaret M. ; Jones, Brian A. ; Hull, Melissa A. ; Misra, Meghna V. ; Smithers, Charles J. ; Feins, Neil R. ; Jenkins, Roger L. ; Lillehei, Craig W. ; Harmon, William E. ; Jonas, Maureen M. ; Kim, Heung B. / Combined en bloc liver-double kidney transplantation in an infant with IVC thrombosis. In: Pediatric Transplantation. 2011 ; Vol. 15, No. 7. pp. E142-E144.
@article{41c778a3a99544beafa8ea8906241a9e,
title = "Combined en bloc liver-double kidney transplantation in an infant with IVC thrombosis",
abstract = "We report a case of a pediatric en bloc liver-double kidney transplant in a patient with IVC thrombosis below the renal veins. The patient is an 11-month-old girl diagnosed with congenital nephrotic syndrome at two months of age. Multifocal liver masses were identified on routine ultrasound at eight months of age. Alpha fetoprotein level was 55 319. Biopsy confirmed hepatoblastoma. CT scan confirmed multiple lesions in both lobes, which would require liver transplantation for resection. She was also found to have thrombosis of her infrarenal IVC secondary to multiple central lines. She was listed for combined liver-kidney transplant and began chemotherapy. After four cycles of chemotherapy, she underwent bilateral nephrectomies followed by a combined en bloc liver-double kidney transplant from a size matched donor. In order to provide adequate venous outflow from the kidneys in the absence of a recipient infrarenal IVC, the donor liver and kidneys were procured en bloc with a common arterial inflow via the infrarenal aorta and common outflow via the suprahepatic IVC. Kidney transplantation in the absence of adequate recipient venous drainage may require unusual vascular reconstruction techniques. This case demonstrates a novel approach in patients who may require combined liver-kidney transplantation.",
keywords = "hepatoblastoma, inferior vena cava thrombosis, pediatric kidney transplantation, pediatric liver transplantation, surgery",
author = "McGuire, {Margaret M.} and Jones, {Brian A.} and Hull, {Melissa A.} and Misra, {Meghna V.} and Smithers, {Charles J.} and Feins, {Neil R.} and Jenkins, {Roger L.} and Lillehei, {Craig W.} and Harmon, {William E.} and Jonas, {Maureen M.} and Kim, {Heung B.}",
year = "2011",
month = "11",
day = "1",
doi = "10.1111/j.1399-3046.2010.01328.x",
language = "English (US)",
volume = "15",
pages = "E142--E144",
journal = "Pediatric Transplantation",
issn = "1397-3142",
publisher = "Wiley-Blackwell",
number = "7",

}

TY - JOUR

T1 - Combined en bloc liver-double kidney transplantation in an infant with IVC thrombosis

AU - McGuire, Margaret M.

AU - Jones, Brian A.

AU - Hull, Melissa A.

AU - Misra, Meghna V.

AU - Smithers, Charles J.

AU - Feins, Neil R.

AU - Jenkins, Roger L.

AU - Lillehei, Craig W.

AU - Harmon, William E.

AU - Jonas, Maureen M.

AU - Kim, Heung B.

PY - 2011/11/1

Y1 - 2011/11/1

N2 - We report a case of a pediatric en bloc liver-double kidney transplant in a patient with IVC thrombosis below the renal veins. The patient is an 11-month-old girl diagnosed with congenital nephrotic syndrome at two months of age. Multifocal liver masses were identified on routine ultrasound at eight months of age. Alpha fetoprotein level was 55 319. Biopsy confirmed hepatoblastoma. CT scan confirmed multiple lesions in both lobes, which would require liver transplantation for resection. She was also found to have thrombosis of her infrarenal IVC secondary to multiple central lines. She was listed for combined liver-kidney transplant and began chemotherapy. After four cycles of chemotherapy, she underwent bilateral nephrectomies followed by a combined en bloc liver-double kidney transplant from a size matched donor. In order to provide adequate venous outflow from the kidneys in the absence of a recipient infrarenal IVC, the donor liver and kidneys were procured en bloc with a common arterial inflow via the infrarenal aorta and common outflow via the suprahepatic IVC. Kidney transplantation in the absence of adequate recipient venous drainage may require unusual vascular reconstruction techniques. This case demonstrates a novel approach in patients who may require combined liver-kidney transplantation.

AB - We report a case of a pediatric en bloc liver-double kidney transplant in a patient with IVC thrombosis below the renal veins. The patient is an 11-month-old girl diagnosed with congenital nephrotic syndrome at two months of age. Multifocal liver masses were identified on routine ultrasound at eight months of age. Alpha fetoprotein level was 55 319. Biopsy confirmed hepatoblastoma. CT scan confirmed multiple lesions in both lobes, which would require liver transplantation for resection. She was also found to have thrombosis of her infrarenal IVC secondary to multiple central lines. She was listed for combined liver-kidney transplant and began chemotherapy. After four cycles of chemotherapy, she underwent bilateral nephrectomies followed by a combined en bloc liver-double kidney transplant from a size matched donor. In order to provide adequate venous outflow from the kidneys in the absence of a recipient infrarenal IVC, the donor liver and kidneys were procured en bloc with a common arterial inflow via the infrarenal aorta and common outflow via the suprahepatic IVC. Kidney transplantation in the absence of adequate recipient venous drainage may require unusual vascular reconstruction techniques. This case demonstrates a novel approach in patients who may require combined liver-kidney transplantation.

KW - hepatoblastoma

KW - inferior vena cava thrombosis

KW - pediatric kidney transplantation

KW - pediatric liver transplantation

KW - surgery

UR - http://www.scopus.com/inward/record.url?scp=80054990454&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80054990454&partnerID=8YFLogxK

U2 - 10.1111/j.1399-3046.2010.01328.x

DO - 10.1111/j.1399-3046.2010.01328.x

M3 - Article

C2 - 20412506

AN - SCOPUS:80054990454

VL - 15

SP - E142-E144

JO - Pediatric Transplantation

JF - Pediatric Transplantation

SN - 1397-3142

IS - 7

ER -