Combined liver-kidney transplantation in polycystic disease: Our experience and literature review

doi:10.4240/wjgs.119023

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Surg. Jun 27, 2026; 18(6): 119023
Published online Jun 27, 2026. doi: 10.4240/wjgs.119023

Combined liver-kidney transplantation in polycystic disease: Our experience and literature review

Alessandro Tropea, Duilio Pagano, Salvatore Piazza, Sergio Calamia, Sergio Li Petri, Fabrizio di Francesco, Pasquale Bonsignore, Irene Vitale, Ivan Vella, Caterina Accardo, Federica Chimenti, Paola Salis, Barbara Buscemi, Xing Lai, Alessandro Mattina, Salvatore Gruttadauria

Alessandro Tropea, Duilio Pagano, Salvatore Piazza, Sergio Calamia, Sergio Li Petri, Fabrizio di Francesco, Pasquale Bonsignore, Irene Vitale, Ivan Vella, Caterina Accardo, Paola Salis, Barbara Buscemi, Xing Lai, Alessandro Mattina, Salvatore Gruttadauria, IRCCS ISMETT, Palermo 90127, Italy

Alessandro Tropea, Duilio Pagano, Salvatore Piazza, Sergio Calamia, Sergio Li Petri, Fabrizio di Francesco, Pasquale Bonsignore, Irene Vitale, Ivan Vella, Caterina Accardo, Paola Salis, Barbara Buscemi, Alessandro Mattina, Salvatore Gruttadauria, UPMC Italy, Palermo 90127, Italy

Federica Chimenti, Department of General Surgery, Milano Bicocca University Hospital, Monza 20126, Italy

Xing Lai, Department of Hepatobiliary Surgery, The People’s Hospital of Tongnan District Chongqing City, Chongqing 400010, China

Salvatore Gruttadauria, Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania 95123, Italy

Co-corresponding authors: Alessandro Tropea and Salvatore Gruttadauria.

Author contributions: Tropea A and Gruttadauria S contributed equally to this manuscript and are co-corresponding authors. Tropea A conceived the study and coordinated the work; Pagano D, Piazza S, Calamia S, Li Petri S, di Francesco F, Bonsignore P, Vitale V, Vella I, Accardo C, Salis P, and Buscemi B contributed to the literature search and manuscript drafting; Chimenti F, Lai X, and Mattina A collected and analyzed the case-series data; Gruttadauria S supervised the entire project; and all authors have read and approved the final manuscript.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Corresponding author: Alessandro Tropea, MD, PhD, IRCCS ISMETT, Via E. Tricomi, 5, Palermo 90127, Italy. atropea@ismett.edu

Received: January 28, 2026
Revised: February 27, 2026
Accepted: March 26, 2026
Published online: June 27, 2026
Processing time: 142 Days and 15 Hours

Core Tip

Core Tip: Polycystic liver-kidney disease is a rare but debilitating condition requiring combined liver-kidney transplantation. This evidence review integrates contemporary data with our single-centre series (ISMETT, 2008-2025) of 20 combined liver-kidney transplantations for polycystic disease. The results show 95% patient survival (95% confidence interval: 86%-100%) at 1 year, 3 years, and 5 years after transplant and two kidney graft losses. We summarise actionable selection and technical considerations, such as symptom-driven liver listing, renal trajectory, and selective native nephrectomy, and emphasise innovations including liver-mediated immunoprotection and hypothermic machine perfusion, which enable delayed kidney implantation and the safer use of extended criteria donors.