Outcomes of Simultaneous Liver-Kidney Transplantation (SLK) from Donation after Cardiac Death (DCD) Donors and from Donation after Brain Death Donors (DBD)
Transplantation, Mayo Clinic, Jacksonville, FL
Meeting: 2013 American Transplant Congress
Abstract number: D1688
Data concerning outcomes of SLK tx from DCD donors is lacking. Methods: Patient and graft survivals were compared between 12 DCD-SLK and 54 DBD-SLK performed between 4/2000 and 8/2010. Rates of surgical complications, infections, rejections occurring within the first post-tx year and 1-year serum creatinine were also compared between the 2 groups.Results: Characteristics and post-tx complications are presented in tabular format.
| DBD-SLK (n=54) | DCD-SLK (n=12) | P | |
|---|---|---|---|
| Age at tx (yrs) | 57±10 | 54±10 | 0.4 |
| % Male | 65 | 67 | 0.9 |
| MELD score at tx | 23±6 | 23±6 | 0.5 |
| BMI | 27±5 | 29±8 | 0.4 |
| % pre-tx diabetes | 39 | 58 | 0.3 |
| %HCV | 35 | 42 | 0.7 |
| %Dialysis at tx | 48 | 67 | 0.3 |
| Operative time (hrs) | 6.8 ± 2.4 | 5.6 ± 1.9 | 0.09 |
| Donor age (yrs) | 33±14 | 31±12 | 0.9 |
| %Biliary complications | 11 | 25 | 0.3 |
| %Urological complications | 13 | 0 | 0.3 |
| %Vascular complications | 11 | 0 | 0.6 |
| %Wound infection | 13 | 17 | 0.7 |
| %Re-operations | 20 | 33 | 0.4 |
| % Liver primary non-function | 0 | 8 | 0.1 |
| % kidney DGF | 21 | 42 | 0.1 |
| %peritonitis | 11 | 42 | 0.02 |
| %Bacteremia | 15 | 33 | 0.2 |
| %Kidney rejection | 11 | 17 | 0.6 |
| %Liver rejection | 33 | 17 | 0.3 |
All patients receive prednisone, tacrolimus and mycophenolate mofetil for maintenance IS. 1-year serum creatinine was comparable between DBD-SLK and DCD-SLK (1.3 ± 0.4 (n=41) vs 1.5 ± 0.8(n=9) mg/dl, respectively, P=0.8).1-year patient, liver and kidney survivals were similar between DCD and DBD (83%, 75% and 82% versus 92%, 92%, 91%, respectively, P>0.05) but DCD-SLK had worse patient, liver and kidney survivals at 3 (83%, 62% and 59% versus 90%, 90% and 91%, respectively, P=0.03 for all) and 5 year (59%, 62% and 59% versus 87%, 87% and 88%, respectively, P<0.05 for all). Figure represents patient survival for DBD-SLK vs DCD-SLK.
Conclusions: 1)1-year surgical complications, infections, rejections and kidney function are comparable between DCD-SLK and DBD-SLK. 2) Patient and grafts survivals are similar in DCD-SLK to DBD-SLK only in the first post-tx year with worse patient and grafts survivals afterwards. 3)DCD-SLK may be advisable for transplant candidates with limited post-transplant life expectancy.
To cite this abstract in AMA style:
Wadei H, Bulatao I, Gonwa T, Keaveny A, Mai M, Taner B. Outcomes of Simultaneous Liver-Kidney Transplantation (SLK) from Donation after Cardiac Death (DCD) Donors and from Donation after Brain Death Donors (DBD) [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/outcomes-of-simultaneous-liver-kidney-transplantation-slk-from-donation-after-cardiac-death-dcd-donors-and-from-donation-after-brain-death-donors-dbd/. Accessed November 22, 2024.« Back to 2013 American Transplant Congress