ATC Abstracts

American Transplant Congress abstracts

  • Home
  • Meetings Archive
    • 2022 American Transplant Congress
    • 2021 American Transplant Congress
    • 2020 American Transplant Congress
    • 2019 American Transplant Congress
    • 2018 American Transplant Congress
    • 2017 American Transplant Congress
    • 2016 American Transplant Congress
    • 2015 American Transplant Congress
    • 2013 American Transplant Congress
  • Keyword Index
  • Resources
    • 2021 Resources
    • 2016 Resources
      • 2016 Welcome Letter
      • ATC 2016 Program Planning Committees
      • ASTS Council 2015-2016
      • AST Board of Directors 2015-2016
    • 2015 Resources
      • 2015 Welcome Letter
      • ATC 2015 Program Planning Committees
      • ASTS Council 2014-2015
      • AST Board of Directors 2014-2015
      • 2015 Conference Schedule
  • Search

Outcomes of Sensitized Simultaneous Liver-Kidney Transplant

E. R. Kitchel, T. Tan, A. Wadhwa, D. G. Farmer, S. Bunnapradist

David Geffen School of Medicine, Los Angeles, CA

Meeting: 2022 American Transplant Congress

Abstract number: 1081

Keywords: Kidney/liver transplantation, Outcome, Sensitization

Topic: Clinical Science » Liver » 52 - Liver: Kidney Issues in Liver Transplantation

Session Information

Session Name: Liver: Kidney Issues in Liver Transplantation

Session Type: Poster Abstract

Date: Sunday, June 5, 2022

Session Time: 7:00pm-8:00pm

 Presentation Time: 7:00pm-8:00pm

Location: Hynes Halls C & D

*Purpose: Pre-formed donor-specific HLA antibodies (DSAs) in simultaneous liver-kidney transplants (SLKTs) have been associated with increased risk of antibody mediated rejection (AMR) and negative transplant outcomes. There is a lack of consensus in immunosuppression management as well as immunogenic testing in this population. SLKT candidates at our center undergo HLA antibody testing at time of listing and single antigen testing (SAT) and crossmatch at time of transplant. We evaluated outcomes among sensitized (calculated PRA >30%, positive DSA, or positive crossmatch) and non-sensitized SLKTs at our center.

*Methods: We performed a single-center, retrospective review of adult de novo SLKTs performed between 2018-2021. All patients received basiliximab induction and maintenance immunosuppression with tacrolimus, mycophenolate, and prednisone. Primary outcomes were incidence of graft rejection and patient and graft survival at 1 year. Secondary outcome was development of de novo DSA.

*Results: Of 47 SLKTs, 13 were sensitized. 62% of patients in the sensitized group exhibited HLA Class II DSAs. Graft rejection was noted in 3 sensitized patients (2 kidney, 1 liver) and in 2 non-sensitized patients (1 kidney, 1 liver) and all were acute T-cell mediated. One non-sensitized patient experienced kidney graft failure while no sensitized patients did. No incidences of liver graft failure were reported in either group. No patients developed de novo DSAs. Death within the first year post transplant occurred in 2 sensitized patients and 1 non-sensitized patient.

*Conclusions: In this series of contemporary SLKTs, 27.7% were sensitized at the time of transplant. Sensitized patients exhibited a higher incidence of kidney rejection and death. There seemed to be no effect on the liver graft. Despite basiliximab induction, there were no cases of AMR and no development of de novo DSAs reported in either group. Overall differences may be related to sample size and longer follow-up may be needed to better assess long term outcomes including incidence of late onset AMR.

Patient Demographics
Sensitized (n=13) Non-sensitized (n=34)
Age, mean 57.6 54.7
ETOH as cause of liver disease, n(%) 5(38.5%) 15(44.1)
HRS as cause of renal disease, n(%) 11(84.6%) 26(76.5%)
MELD at transplant (Median) 38 37
cPRA >30%, n(%) 4(30.8%) 0(0%)
Crossmatch positive, n(%) 5(38.5%) 0(0%)
Class I/II DSA positive, n(%) 2(15.4%)/8(61.5%) 0(0%)/1(2.9%)
Transplant Outcomes
Sensitized (n=13) Non-sensitized (n=34)
Graft loss, n(%) 0(0%) 1(2.9%)
Patient mortality within 1 year, n(%) 2(15.4%) 1(2.9%)
DGF, n(%) 5(38.5%) 18(52.9%)
Renal function (SCr, mg/dL), 6m median/1y median 1.08/1.21 1.27/1.19
Liver function (AST or ALT >3x normal upper limit), n(%) 0(0%) 0(0%)
Kidney rejection within 1 year, n(%) 2(15.4%) 1(2.9%)
Liver rejection within 1 year, n(%) 1(7.7%) 1(2.9%)
  • Tweet
  • Email
  • Print

To cite this abstract in AMA style:

Kitchel ER, Tan T, Wadhwa A, Farmer DG, Bunnapradist S. Outcomes of Sensitized Simultaneous Liver-Kidney Transplant [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/outcomes-of-sensitized-simultaneous-liver-kidney-transplant/. Accessed May 8, 2025.

« Back to 2022 American Transplant Congress

Visit Our Partner Sites

American Transplant Congress (ATC)

Visit the official site for the American Transplant Congress »

American Journal of Transplantation

The official publication for the American Society of Transplantation (AST) and the American Society of Transplant Surgeons (ASTS) »

American Society of Transplantation (AST)

An organization of more than 3000 professionals dedicated to advancing the field of transplantation. »

American Society of Transplant Surgeons (ASTS)

The society represents approximately 1,800 professionals dedicated to excellence in transplantation surgery. »

Copyright © 2013-2025 by American Society of Transplantation and the American Society of Transplant Surgeons. All rights reserved.

Privacy Policy | Terms of Use | Cookie Preferences