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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Clin+Transplant
2015 ; 29
(1
): 34-43
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gab.com Text
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English Wikipedia
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.