Purpose: Increased rates of delayed graft function (DGF) after simultaneous liver kidney (SLK) transplantation have been described, as well as inferior graft survival in patients who experience DGF. Our goal was to determine donor and recipient factors contributing to this risk.

Methods: We studied 6262 adult SLK recipients using data from the Scientific Registry of Transplant Recipients from Mar 2002 – Feb 2017. We determined the association between donor and recipient risk factors and DGF using multivariate logistic regression. Further, we determined the association between DGF and mortality and graft failure using Cox proportional hazard analysis, adjusting for multiple donor and recipient factors.

Results: The overall rate of DGF was 21.6%. Risk factors for DGF included recipient age, pre-transplant dialysis, and transplantation with a DCD or regionally or nationally shared donor. One year patient survival was 86.7%, one year death censored kidney survival was 94.0%, and one year liver graft survival was 85.5%. In multivariate analysis, DGF was the most significant risk factor for mortality (aHR 1.48, p < 0.001) and kidney graft failure (aHR 2.79, p < 0.001). DGF was also significantly associated with liver graft failure (aHR 1.46, p < 0.001).

Conclusions: Similar to kidney alone transplantation, in SLK recipients, components of kidney graft quality and recipient pre-transplant dialysis comprise significant risk factors for DGF. DGF in SLK recipients is a significant risk factor for long term patient mortality and graft morbidity.

CITATION INFORMATION: Weeks S., Luo X., Ottmann S., Gurakar A., Naqvi F., Philosophe B., Cameron A., Desai N., Segev D., Garonzik Wang J. Delayed Graft Function in Simultaneous Liver Kidney Transplantation Am J Transplant. 2017;17 (suppl 3).

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