Survival and renal function after liver transplantation alone in patientsmeeting the new United Network for Organ Sharing simultaneous liver-kidney criteria

Da David Jiang, Kayvan Roayaie, David Woodland, Susan Orloff, David Scott

Research output: Contribution to journalArticlepeer-review

Abstract

In 2017, United Network for Organ Sharing (UNOS) implemented a simultaneous liver-kidney transplant (SLK) allocation policy. Our institution uses a more restrictive criteria for SLK; thus, we have a group of patients that would have qualified for SLK under the new allocation policy but received liver transplantation alone (LTA). We compared survival and post-operative renal function in patients that received LTA stratified by whether they met the new UNOS SLK criteria. There was no difference in graft and patient survival. The majority (95%) of LTA patients meeting the UNOS SLK criteria did not need dialysis at 1 year, with a mean eGFR increase from 23 mL/min preoperatively to 48 mL/min at 1 year. Of those with eGFR ≤ 20 mL/min at 1 month after surgery, the majority did regain adequate renal function. The implementation of the UNOS SLK allocation policy was appropriate in the previously unregulated area. This policy provides an excellent framework for those that may benefit from SLK. Our data suggest that a more restrictive policy may be possible in order to promote the best use of donated organs. The current safety net is appropriately positioned to capture patients in need of subsequent kidney transplant.

Original languageEnglish (US)
Article numbere14020
JournalClinical Transplantation
Volume34
Issue number10
DOIs
StatePublished - Oct 1 2020

Keywords

  • Organ Procurement Transplant Network
  • United Network for Organ Sharing
  • allocation policy
  • simultaneous liver-kidney

ASJC Scopus subject areas

  • Transplantation

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