Outcomes of Liver Transplantation Alone After Listing for Simultaneous Kidney. Issue 4 (April 2015)

• Record Type: Journal Article
• Authors: Hmoud, Bashar; Kuo, Yong-Fang; Wiesner, Russell H.; Singal, Ashwani K.
• Is Part Of: Transplantation. Volume 99:Issue 4(2015)
• Publication Date: 2015-04
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; Transplantation immunology -- Periodicals; 617.95
• DOI: 10.1097/TP.0000000000000438
• Languages: English
• ISSNs: 0041-1337

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Background</title> <p>Data on patient and liver graft survival comparing liver transplantation alone after listing for kidney with simultaneous liver kidney (SLK) transplantation are scanty.</p> </sec> <sec> <title>Methods</title> <p>United Network Organ Sharing network database (1994–2011) queried for liver transplantation alone after being listed for kidney and SLK transplants.</p> </sec> <sec> <title>Results</title> <p>Of 65, 206 first liver transplants, 3549 were listed for simultaneous kidney. Of these, 422 (12%) received only liver (LIST) and differed from SLK recipients for the white race (64% vs. 57%; 0.005), diabetes (27% vs. 37%; <italic>P</italic> = 0.02), model for end-stage liver disease era (68% vs. 82%; <italic>P</italic> = 0.0001), serum creatinine (2.9±1.9 vs. 4.3±2.5; <italic>P</italic> < 0.0001), dialysis (35% vs. 64%; <italic>P</italic> < 0.0001), and donor risk index (1.6±0.4 vs. 1.5±0.3; <italic>P</italic> < 0.0001). Overall survival was poorer in the LIST group (55% vs. 76%; <italic>P</italic> < 0.0001). A higher proportion of patients died within 2 days of transplantation in LIST group (11% vs. 0.5%; <italic>P</italic> < 0.0001), mostly from cardiovascular causes. After excluding these patients, odds of patient mortality and liver graft loss were about 1.2-fold and twofold higher in the LIST group. A total of 103 (24%) patients needed a renal transplantation in the LIST group with 16 (4%) receiving kidney within first year after transplantation. After excluding patients receiving kidney within first year, about 33% recovered renal function to above estimated GFR of greater than 60 mL per min.</p> </sec> <sec> <title>Conclusion</title> <p>Guidelines are needed for patient selection to list for and receipt of simultaneous liver kidney transplantation.</p> </sec> </abstract>