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10.1111/ctr.12479

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suck abstract from ncbi


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pmid25328090
      Clin+Transplant 2015 ; 29 (1 ): 34-43
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  • Renal outcomes of simultaneous liver-kidney transplantation compared to liver transplant alone for candidates with renal dysfunction #MMPMID25328090
  • Brennan TV ; Lunsford KE ; Vagefi PA ; Bostrom A ; Ma M ; Feng S
  • Clin Transplant 2015[Jan]; 29 (1 ): 34-43 PMID25328090 show ga
  • It is unclear whether a concomitant kidney transplant grants survival benefit to liver transplant (LT) candidates with renal dysfunction (RD). We retrospectively studied LT candidates without RD (n = 714) and LT candidates with RD who underwent either liver transplant alone (RD-LTA; n = 103) or simultaneous liver-kidney transplant (RD-SLKT; n = 68). RD was defined as renal replacement therapy (RRT) requirement or modification of diet in renal disease (MDRD)-glomerular filtration rate (GFR) <25 mL/min/1.73 m(2) . RD-LTAs had worse one-yr post-transplant survival compared to RD-SLKTs (79.6% vs. 91.2%, p = 0.05). However, RD-LTA recipients more often had hepatitis C (60.2% vs. 41.2%, p = 0.004) and more severe liver disease (MELD 37.9 ± 8.1 vs. 32.7 ± 9.1, p = 0.0001). Twenty RD-LTA recipients died in the first post-transplant year. Evaluation of the cause and timing of death relative to native renal recovery revealed that only four RD-LTA recipients might have derived survival benefit from RD-SLKT. Overall, 87% of RD-LTA patients recovered renal function within one month of transplant. One yr after RD-LTA or RD-SLKT, serum creatinine (1.5 ± 1.2 mg/dL vs. 1.4 ± 0.5 mg/dL, p = 0.63) and prevalence of stage 4 or 5 chronic kidney disease (CKD; 5.9% vs. 6.8%, p = 0.11) were comparable. Our series provides little evidence that RD-SLKT would have yielded substantial short-term survival benefit to RD-LTA recipients.
  • |*Kidney Transplantation/mortality [MESH]
  • |*Liver Transplantation/mortality [MESH]
  • |Adolescent [MESH]
  • |Adult [MESH]
  • |Aged [MESH]
  • |Aged, 80 and over [MESH]
  • |End Stage Liver Disease/complications/mortality/*surgery [MESH]
  • |Female [MESH]
  • |Follow-Up Studies [MESH]
  • |Humans [MESH]
  • |Kaplan-Meier Estimate [MESH]
  • |Kidney Function Tests [MESH]
  • |Male [MESH]
  • |Middle Aged [MESH]
  • |Renal Insufficiency/complications/mortality/*surgery [MESH]
  • |Retrospective Studies [MESH]
  • |Severity of Illness Index [MESH]
  • |Treatment Outcome [MESH]


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