Combined Dual-Kidney Liver Transplantation in the United States

A Review of United Network for Organ Sharing/Organ Procurement and Transplantation Network Data Between 2002 and 2012

Grigoriy Shekhtman, Edmund Huang, Gabriel M. Danovitch, Paul Martin, Suphamai Bunnapradist

Research output: Contribution to journalArticle

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Abstract

In kidney-alone recipients, dual-kidney transplantation using “higher-risk” donor organs has shown outcomes comparable to those of single-kidney transplantation using extended criteria donor (ECD) organs. To investigate the feasibility of a similar approach with combined kidney-liver transplantation, we identified 22 dual-kidney liver transplantations (DKLTs) and 3044 single-kidney liver transplantations (SKLTs) performed in the United States between 2002 and 2012 using United Network for Organ Sharing/Organ Procurement and Transplantation Network registry data. We compared donor/recipient characteristics as well as graft/recipient survival between DKLT recipients and SKLT recipients of “higher-risk” kidneys (ECD and high kidney donor profile index [KDPI; >85%] donors). Despite having overall similar donor and recipient characteristics compared with both “higher-risk” donor groups, recipient survival in the DKLT group at 36 months was markedly inferior at 40.9% (compared with 67.5% for ECD SKLT recipients and 64.5% for high-KDPI SKLT recipients); nondeath-censored graft survival did not differ. Death was the most common cause of graft loss in all groups. Contrary to dual-kidney transplantation data in kidney-alone recipients, DKLT recipients in our study had inferior survival when compared with SKLT recipients of “higher-risk” donor kidneys. These findings would suggest that dual kidney-liver transplantation has an uncertain role as a strategy to expand the existing kidney donor pool in combined transplantation.

Original languageEnglish (US)
Pages (from-to)1570-1577
Number of pages8
JournalLiver Transplantation
Volume24
Issue number11
DOIs
StatePublished - Nov 1 2018

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Tissue and Organ Procurement
Organ Transplantation
Liver Transplantation
Kidney Transplantation
Tissue Donors
Kidney
Graft Survival
Survival
Registries

ASJC Scopus subject areas

  • Surgery
  • Hepatology
  • Transplantation

Cite this

Combined Dual-Kidney Liver Transplantation in the United States : A Review of United Network for Organ Sharing/Organ Procurement and Transplantation Network Data Between 2002 and 2012. / Shekhtman, Grigoriy; Huang, Edmund; Danovitch, Gabriel M.; Martin, Paul; Bunnapradist, Suphamai.

In: Liver Transplantation, Vol. 24, No. 11, 01.11.2018, p. 1570-1577.

Research output: Contribution to journalArticle

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