Date: Sunday, May 3, 2015
Session Time: 5:30pm-6:30pm
Presentation Time: 5:30pm-6:30pm
Location: Exhibit Hall E
Introduction: Since initiation of MELD-based allocation for liver transplants, the risk of end-stage renal disease (ESRD) post-liver transplantation has increased. Recent US data demonstrated comparable, if not superior survival, among recipients of living donor liver transplants (LDLT) when compared to deceased donor liver transplant (DDLT) recipients. Little is unknown about the incidence of ESRD after LDLT, and whether LDLT recipients have decreased risk of ESRD compared to DDLT recipients.
Methods: We analyzed linked SRTR and USRDS data of first-time liver-alone transplant recipients from 2/27/02-3/1/2011. We restricted the cohort to patients with a laboratory MELD score <25 who were not on dialysis prior to transplantation given that fewer than 100 LDLT recipients in the US achieved this MELD score at transplantation. We fit multivariable competing risk Cox regression models to compare the unadjusted and adjusted risks of ESRD in LDLT and DDLT recipients.
Results: There were 28,707 DDLT and 1,917 LDLT recipients, respectively, included in the analyses. DDLT recipients had minimally higher laboratory MELD scores at transplantation (median 16 vs 14; p<0.001), but similar serum creatinine values. The unadjusted 1-, 3-, and 5-years risks of ESRD were 1.5% (95% CI: 1.3-1.6%), 3.0% (95% CI: 2.8-3.2%), and 4.8% (95% CI: 4.5-5.1%) in DDLT recipients, respectively, compared with 1.7% (95% CI: 1.2-2.4%), 2.9% (2.2-3.8%), and 3.4% (2.6-4.4%) in LDLT recipients. In multivariable competing risk Cox regression models accounting for the competing risk of death and adjusting for the eGFR at transplantation, the hazard of ESRD post-transplantation was not significantly different in LDLT versus DDLT recipients (sub-hazard ratio: 0.99, 95% CI: 0.77-1.26).
Conclusions: The incidence of ESRD post-LDLT in the US since 2002 is low. There is no significant difference in the incidence of ESRD between LDLT recipients when compared to DDLT recipients with laboratory MELD scores <25 at transplantation.
To cite this abstract in AMA style:Goldberg D, Ruebner R, Abt P. Risk of End-Stage Renal Disease After Living Donor Liver Transplantation: Overall Incidence and Comparisons to Deceased Donor Recipients [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/risk-of-end-stage-renal-disease-after-living-donor-liver-transplantation-overall-incidence-and-comparisons-to-deceased-donor-recipients/. Accessed May 7, 2021.
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