Date: Tuesday, May 2, 2017
Session Time: 2:30pm-4:00pm
Presentation Time: 3:18pm-3:30pm
Background & Aim: The United Network for Organ Sharing (UNOS) has proposed criteria for simultaneous liver and kidney transplantation (SLK) incorporating strict definitions for eligibility based on the presence of advanced chronic kidney disease or sustained acute kidney injury. Our aim was to assess post-transplant survival and renal function in patients who were eligible for SLK using these criteria but received liver transplantation alone (LT).
Methods: A retrospective review of all LT recipients at a single center from 2006-15 was used to identify recipients with renal insufficiency at the time of LT. Patients dialyzed for > 6 weeks received SLK's and were excluded from review. Chart review determined if patients would have met either the acute (dialysis or glomerular filtration rate (GFR) ≤ 25 mL/min ≤ for 6 weeks), or chronic (GFR ≤ 60 for 90 days and GFR ≤ 30 at LT) SLK criteria. Overall survival and GFR at 1 year were primary outcomes.
Results: The study included 346 LT recipients, 11 (3.2%) met the acute criteria and 43 (12%) met the chronic criteria. In all, 44 (13%) patients would have met UNOS SLK criteria. Patient survival in those who met the SLK criteria (1-yr 95% and 3-yr 77%) and those that did not (1-yr 94% and 3-yr 83%) did not differ significantly (p=0.38). The mean estimated GFR 1 year post transplant was 48 in patients meeting SLK criteria compared to 68 in those who did not. Of 316 patients surviving 1 year after LT, 5 patients (3 from non-qualifying group, 2 from qualifying group) had a GFR < 20. Over the 10 yr study period, 4 of these patients were evaluated for kidney after liver transplant and to date 1 has received a kidney transplant.
Conclusion: Most patients meeting the proposed UNOS SLK criteria recover renal function after LT alone and have excellent long-term survival. More restrictive criteria for SLK with prioritization of renal transplantation for LT recipients without renal recovery may optimally utilize scarce organs without compromising long-term patient outcomes.
CITATION INFORMATION: Roayaie K, Langewisch E, Burg J, Enestvedt C, Maynard E, Scott D. Renal Function After Liver Transplantation Alone in Patients Meeting the Proposed UNOS Simultaneous Liver-Kidney (SLK) Criteria. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Roayaie K, Langewisch E, Burg J, Enestvedt C, Maynard E, Scott D. Renal Function After Liver Transplantation Alone in Patients Meeting the Proposed UNOS Simultaneous Liver-Kidney (SLK) Criteria. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/renal-function-after-liver-transplantation-alone-in-patients-meeting-the-proposed-unos-simultaneous-liver-kidney-slk-criteria/. Accessed April 20, 2021.
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