Date: Saturday, June 1, 2019
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall C & D
*Purpose: Chronic Kidney disease (CKD) is common in patient with Chronic liver disease (CLD). It is difficult to distinguish between CKD and Hepatorenal syndrome (HRS) in the background of CLD. Liver transplantation is the treatment of choice in those patients however the need for kidney transplantation for the recovery of kidney is still debatable. Hence, we aim to analyze the outcomes between Sequential Liver Kidney transplant (LT) versus simultaneous liver kidney transplant (CLKT) in out cohort
*Methods: We retrospectively analyzed data from August 2006 to October 2017. Inclusion criteria was LDLTs, CLD with CKD, and adult transplants. These patients were further subdivided into LT alone vs CLKT. Various parameters were analyzed between the two groups. Subgroup analysis was done based on CKD stage. Calculations were done using SPSS 25 software.
*Results: A total of 100 out of 2182 patients fulfilled the criteria of CKD (more than 3 months of persistent biochemical with or without imaging evidence of CKD) with decompensated CLD were included in the study. 23 patients underwent combined liver kidney transplant (Study Group n=23) and 77 patients underwent liver transplant alone (Control Group n=77). Subgroup analysis was done in both groups based on the CKD stage. Clinically 9 patients in control group were off Calcineurin inhibitors, one patient was on Hemodialysis and 3 have undergone kidney transplant and at the end of the study. On statistical analysis preoperative creatinine was significantly higher (P< 0.001) in study group than controls. The day of peak bilirubin (P< 0.05) was significantly lower in study group. GFR was significantly lower in the study group (P=0.001). Patient survival was better in CKD stage 5 patients who underwent CLKT (Log rank, P < 0.05). In other stages of CKD survival was similar between two groups.
*Conclusions: Sequential liver kidney transplant at first approach is not inferior to CLKT in living donor situations except for CKD stage 5. Renal dysfunction is reversed in many cases while in other cases it gives chance and time to family to arrange suitable Kidney donor.
To cite this abstract in AMA style:Verma S, Naganathan S, Gupta S. Sequential Liver Kidney Transplant Has Comparable Outcomes As Combined Liver Kidney Transplant Except For Ckd 5 In Patient With Cld With Ckd In Live Donor Program- Retrospective Analysis Of 2182 Cases [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/sequential-liver-kidney-transplant-has-comparable-outcomes-as-combined-liver-kidney-transplant-except-for-ckd-5-in-patient-with-cld-with-ckd-in-live-donor-program-retrospective-analysis-of-2182-cases/. Accessed January 24, 2020.
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