Background: The purpose of this study was to evaluate predictors of outcomes in combined liver-kidney (L/K) transplants for PLD/PKD.

Methods: We queried the UNOS dataset for combined L/K transplants performed from 1988 to 2013.

Results: Out of 107 patients that had combined L/K transplants for PLD/PKD, 84 were female (78.5%) with a mean age of 54.9 ±7.2 years. Kaplan-Meier analysis demonstrated that patients undergoing L/K transplantation for PLD/PKD had better survival than patients with PLD undergoing liver transplant alone and those undergoing L/K transplantation for other indications. This group had a 1, 3, and 5 year survival of 91%, 90%, and 90%, respectively. Multivariable analysis demonstrated that an indication of PLD/PKD for combined L/K transplant (hazard ratio 0.29, 95% CI 0.129-0.526, P < 0.001) and MELD score (hazard ratio 1.271, CI 1.093-1.477, P = 0.002) are independently associated with patient survival. In a propensity score analysis adjusting for age, gender, CIT and total bilirubin and excluding hepatitis C, we found that patients transplanted with combined L/K for other indications have similar survival compared to our study group.

Conclusions: Combined L/K transplantation for PLD/PKD can achieve good outcomes in selected patients. On Cox regression analysis, patients with PLD/PKD undergoing L/K transplantation had better survival compared to patients with combined L/K for other indications. After excluding hepatitis C patients, those transplanted for PLD/PKD versus other indications had similar survival after combined L/K transplantation. Interestingly, patients in the combined PLD/PKD group have significantly better outcomes than patients with PLD undergoing liver transplant alone.

CITATION INFORMATION: Coquillard C, Berger J, Daily M, Mei X, Marti F, Shah M, Gedaly R. Combined Liver-Kidney Transplantation for Polycystic Liver and Kidney Disease: Analysis from the UNOS Dataset. Am J Transplant. 2016;16 (suppl 3).

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