Effect of Pretransplant Renal Replacement Therapy on Liver Transplant Outcomes
Surgery, The Methodist Hospital, Houston, TX
Scripps Clinic for Organ Transplantation, Scripps Clinic &
Green Hospital, La Jolla, CA
Medicine, The Methodist Hospital, Houston, TX
Meeting: 2013 American Transplant Congress
Abstract number: D1692
Aim: To evaluate outcomes of cirrhotic patients who received renal replacement therapy prior to liver transplant.
Methods: A retrospective review of cirrhotic patients who received orthotopic liver transplantation (OLT) between April 2008 and July 2012. Out of 194 patients, 53 patients received renal replacement therapy (RRT).
Results: The 53 patients were divided into those who received liver only (n=35) and others who received combined liver kidney transplant; CLKT (n=18). The mean MELD score in the OLT was 39 + 5 SD while in the CLKT 29+ 6 SD. The median waiting times for OLT and CLKT were 15 and 99 days respectively. Post-transplant; 30 patients in the OLT group and 4 in the CLKT group received RRT till full recovery of kidney functions. After 21 months median follow up, survival data are:
| Survival | CLKT (n=18) | OLT + pre Tx RRT (n=35) | OLT without pre transplant RRT (n=141) | P value |
| 1-year patient survival | 78% | 86% | 96% | 0.006 |
| 1-Year graft survival | 78% | 82% | 94% | 0.01 |
| 3-year patient survival | 72% | 83% | 89% | 0.07 |
| 3-year graft survival | 72% | 78% | 88% | 0.003 |
Conclusion:
Post-transplant RRT requirement was higher in the OLT+ pre TxRRT group than CLKT. Patients who received liver only, had a significantly higher MELD scores, shorter waiting time and better survival. This reflects the component of kidney dysfunction that is reversible by restoring liver function. Patient who do not require pre transplant RRT have better 1- year overall survival 3- year graft survival.
To cite this abstract in AMA style:
Asham E, Boktour M, Frenette C, Monsour H, Suki W, Gaber A, Ghobrial R. Effect of Pretransplant Renal Replacement Therapy on Liver Transplant Outcomes [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/effect-of-pretransplant-renal-replacement-therapy-on-liver-transplant-outcomes/. Accessed November 23, 2024.« Back to 2013 American Transplant Congress