Date: Sunday, June 12, 2016
Session Name: Poster Session B: Kidney Issue in Liver Transplantation
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Background: The OPTN listing criteria for Simultaneous liver-kidney transplant (SLK) are not well defined. There are concerns about rising numbers of SLKs, which take kidneys away from candidates awaiting kidney transplants (tx).
Methods: We did a retrospective review of liver transplants at our center from 2004-14 and isolated 141 recipients with short-term pre-op kidney dysfunction (Serum creatinine>4 or requiring dialysis for <6 wks). Primary outcomes compared were renal non-recovery (Dialysis for >3mo after tx), 1 yr mortality, 1 yr graft failure and post-op length of stay (LOS). Multivariate analysis of age and sex adjusted 1 yr mortality of recipients was done.
Results: 114 patients received a liver transplant alone (LTA), 27 patients had SLK. Both cohorts had comparable baseline characteristics. MELD score was significantly higher in the LTA group (p<0.0001), while pre-tx HD days were significantly higher in SLK recipients (p=0.009). 4 LTA recipients and 1 SLK recipient had renal non-recovery (p=1.0). There was no significant difference in 1 yr mortality, liver graft failure or LOS between the cohorts.
|Donor age (yrs)||Mean(SD)||41.55(16.87)||41.03(15.55)||0.88|
|Pre-tx HD days||Median||6||13||0.009|
|1 year mortality||n(%)||16(14.04)||4(14.81)||>0.99|
|1 year graft failure||n||5||0||0.58|
Age and sex adjusted multivariate analysis did not show any association of one-year mortality with type of transplant.
|Adjusting variable||OR||p value|
|Pre-tx HD days||0.78||0.74|
|Post-tx HD days||0.52||0.47|
There has been a decline in proportion of SLK recipients in the last 5 years (14.5%) compared to the first 5 years (24.6%).
Conclusions: Most patients with short-term (<6 wks) dialysis or AKI without dialysis do well with Liver transplant alone and do not need a simultaneous kidney transplant. The UNOS criteria for SLK need to be clearly defined. Role of early Kidney after liver transplant needs to be established for patients with renal non-recovery.
CITATION INFORMATION: Yadav K, Pruett T, Kandaswamy R, Payne W, Zhang L, Chinnakotla S. Liver Recipient with Renal Dysfunction: Liver Only or Simultaneous Liver-Kidney Transplant? Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:Yadav K, Pruett T, Kandaswamy R, Payne W, Zhang L, Chinnakotla S. Liver Recipient with Renal Dysfunction: Liver Only or Simultaneous Liver-Kidney Transplant? [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/liver-recipient-with-renal-dysfunction-liver-only-or-simultaneous-liver-kidney-transplant/. Accessed April 20, 2021.
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