Differential Simultaneous Liver and Kidney Transplant Benefit Based on Severity of Liver Damage at the Time of Transplantation

Gastroenterology Research
Shahid HabibThomas Boyer

Abstract

We evaluated the concept of whether liver failure patients with a superimposed kidney injury receiving a simultaneous liver and kidney transplant (SLKT) have similar outcomes compared to patients with liver failure without a kidney injury receiving a liver transplantation (LT) alone. Using data from the United Network of Organ Sharing (UNOS) database, patients were divided into five groups based on pre-transplant model for end-stage liver disease (MELD) scores and categorized as not having (serum creatinine (sCr) ≤ 1.5 mg/dL) or having (sCr > 1.5 mg/dL) renal dysfunction. Of 30,958 patients undergoing LT, 14,679 (47.5%) had renal dysfunction, and of those, 5,084 (16.4%) had dialysis. Survival in those (liver failure with renal dysfunction) receiving SLKT was significantly worse (P < 0.001) as compared to those with sCr < 1.5 mg/dL (liver failure only). The highest mortality rate observed was 21% in the 36+ MELD group with renal dysfunction with or without SLKT. In high MELD recipients (MELD > 30) with renal dysfunction, presence of renal dysfunction affects the outcome and SLKT does not improve survival. In low MELD recipients (16 - 20), presence of renal dysfunction at the time of transplantation does affect post-transplant su...Continue Reading

Citations

Apr 27, 2018·Journal of Gastroenterology and Hepatology·Shahid HabibInnocent Twesigye
Oct 29, 2018·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Miklos Z MolnarUNKNOWN Global NAFLD Consortium
Sep 20, 2017·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Dana Tedesco, Arash Grakoui
Jan 23, 2018·Current Opinion in Organ Transplantation·Lafaine GrantAmit G Singal
Sep 17, 2020·Transplantation Proceedings·Douglas DrakDavid M Gracey
Mar 19, 2021·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Mariya L SamoylovaLisa M McElroy

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Software Mentioned

Statistical Analysis System ( SAS
Statistical Package for the Social Sciences ( SPSS

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