Combined liver–kidney transplantation: 40 years of saving lives

Since the first successful combined liver–kidney transplantation reported in The Lancet in 1984,1 this procedure has evolved into a preferred treatment for patients with end-stage liver disease and end-stage kidney disease. Since the Model for End-stage Liver Disease scoring system was introduced for organ allocation candidates on the waitlist in 2002, the number of combined liver–kidney transplantations has increased rapidly worldwide. To optimise the physiological environment of transplantations and patient outcomes, improved surgical techniques have been developed, such as delayed implantation of kidney grafts in combined liver–kidney transplantation.5 Cold ischaemic time has a negative effect on post-transplantation outcomes.6,7 To reduce the cold ischaemic time for kidney transplantations and overall surgical time, our team proposed a novel surgical technique (with two sub-techniques) for simultaneous orthotopic transplantation of liver and kidney with a single incision (named the Sun technique). XS declares funding from the High-Level Medical Expert Training Program of Guangxi 139 Plan Funding (G202002016) and Guangxi Key Research and Development Program (AB24010059).