Outcomes and native renal recovery following simultaneous liver-kidney transplantation

Levitsky, J.; Baker, T.; Ahya, S. N.; Levin, M. L.; Friedewald, J.; Gallon, L.; Ho, B.; Skaro, A.; Krupp, J.; Wang, E.; Spies, S. M.; Salomon, D. R.; Abecassis, M. M.

Am J Transplant. 2012 Jul 5; 12(11):2949-57


With the increase in patients having impaired renal function at liver transplant due to MELD, accurate predictors of posttransplant native renal recovery are needed to select candidates for simultaneous liver-kidney transplantation (SLK). Current UNOS guidelines rely on specific clinical criteria for SLK allocation. To examine these guidelines and other variables predicting nonrecovery, we analyzed 155 SLK recipients, focusing on a subset (n = 78) that had post-SLK native GFR (nGFR) determined by radionuclide renal scans. The 77 patients not having renal scans received a higher number of extended criteria donor organs and had worse posttransplant survival. Of the 78 renal scan patients, 31 met and 47 did not meet pre-SLK UNOS criteria. The UNOS criteria were more predictive than our institutional criteria for all nGFR recovery thresholds (20-40 mL/min), although at the most conservative cut-off (nGFR

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