Postoperative follow-up and long-term outcome of combined liver–kidney transplantations

Introduction: The use of combined liver-kidney transplantation (CLKT) in the management of patients with concomitant failure of both organs is becoming increasingly common. However, European data regarding postoperative outcomes and long-term prognosis in adult patients remain limited. This study aimed to describe short- and long-term outcomes after CLKT in a multicentre French cohort. Material and Methods: We conducted a retrospective observational study including all adult patients who underwent CLKT between January 2010 and December 2024 across three Parisian transplant centers. Data were collected from institutional medical records and the national registry of the Agence de la biomédecine. Variables analyzed included recipient and donor characteristics, perioperative parameters, immunological data, and postoperative outcomes. Survival was estimated using the Kaplan-Meier method. Results: Forty-one patients were included (median age 53 years; 71% male). The main indications were cirrhosis (46%) and polycystic liver–kidney disease (39%). DGF occurred in 42% of patients and was significantly associated with postoperative complications (p=0.012), and long-term dialysis (p