Table I.

Risk/benefit considerations in decisions regarding kidney transplant versus combined liver-kidney transplant in ARPKD/CHF patients with dual organ involvement. Rare, uncommon problems in italics.

Kidney Transplant	Combined Liver-Kidney Transplant
Morbidity
Portal hypertension: GI bleeding, hypersplenism, protein loosing enteropathy	Surgical complications of liver transplant: primary non-function, hepatic artery thrombosis, portal vein thrombosis/stenosis, bile duct strictures. Donor complications (if living donor partial hepatectomy)
Cholangitis/sepsis
Malignant and benign liver tumors
Cholestasis: failure to thrive, bone disease, intractable pruritus	Liver rejection
Complications of immunosuppression: nephrotoxicity, neurotoxicity, bone marrow suppression, hearing deficits, bone disease, infections (viral, bacterial, fungal and parasitic), PTLD, kidney rejection (possible dialysis), lymphomas and other immunosuppression related malignancies.
Mortality
Ascending cholangitis/sepsis	Surgical complications of liver transplant: primary non-function, hepatic artery thrombosis Donor complications (if living donor partial hepatectomy)
Gastrointestinal bleeding
Malignant and benign liver tumors
Complications of porto-systemic shunt (if needed)
Complications of immunosuppression: nephrotoxicity, infections (viral, bacterial, fungal and parasitic), PTLD, kidney rejection (and following dialysis), lymphomas and other immunosuppression related malignancies