Simultaneous Liver-Kidney Transplants Using Donation After Cardiac Death Donors Long Term Outcomes Not Inferior to Brain Dead Donors.
University of Maryland School of Medicine, Baltimore, MD
Meeting: 2017 American Transplant Congress
Abstract number: D190
Keywords: Allocation, Donors, Liver transplantation, non-heart-beating, Outcome
Session Information
Session Name: Poster Session D: Liver - Kidney Issues in Liver Transplantation
Session Type: Poster Session
Date: Tuesday, May 2, 2017
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
Background:
The Simultaneous use of both Liver and Kidney from the same DCD donor has become controversial with some authors advocating that DCD organs should not be used for SLK transplantation. SLK outcomes are reported as inferior to liver transplant alone outcomes , and limited data has suggested associations of DCD donor status with even poorer SLK outcomes. We investigated DCD SLK outcomes at our institution over the last decade.
Methods:
We performed a single center retrospective analysis of consecutive SLKs from 2005 to 2016. Fisher's exact tests and Wilcoxon signed-rank tests were used to compare recipient and donor factors between the DCD and DBD groups. Cox proportional hazard models were used for the survival analysis. Mean follow-up for the DBD group was 3.48 years Vs. 3.20years for the DCD group.
Results:
Eighty-five patients underwent DCD SLK during the study period. Of these, 74 were recipients of DBD livers and 11 were recipients of DCD. DCD donors were younger than DBD (median 22 yo vs 37.5, p<0.01). MELD scores were similar between DCD and DBD groups (26 vs 30, p=0.2). CIT were the same between groups (<5 hrs), and peak AST, ALT, and Bili were likewise similar. INR at 1-week was slightly higher in the DCD vs. DBD group (1.4 vs 1.2, p<0.05). One patient from each group developed ischemic cholangiopathy (p=0.2). Patient survival, kidney graft, and liver graft survival rates were not different between DCD and DBD SLK recipients.
Conclusions:
DCD SLK were better than expected when compared with DBD SLK. Early DCD graft losses may have been balanced by younger donor age. These data support equal consideration of DCD and DBD donors for recipients listed for simultaneous liver-kidney transplantation.
CITATION INFORMATION: Alvarez-Casas J, Sultan S, Scalea J, McClure K, LaMattina J, Bruno D, Hanish S, Barth R. Simultaneous Liver-Kidney Transplants Using Donation After Cardiac Death Donors Long Term Outcomes Not Inferior to Brain Dead Donors. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Alvarez-Casas J, Sultan S, Scalea J, McClure K, LaMattina J, Bruno D, Hanish S, Barth R. Simultaneous Liver-Kidney Transplants Using Donation After Cardiac Death Donors Long Term Outcomes Not Inferior to Brain Dead Donors. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/simultaneous-liver-kidney-transplants-using-donation-after-cardiac-death-donors-long-term-outcomes-not-inferior-to-brain-dead-donors/. Accessed November 21, 2024.« Back to 2017 American Transplant Congress