Simultaneous liver kidney transplantation

Ashwani K. Singal, Song Ong, Sanjaya Satapathy, Patrick S. Kamath, Russel H. Wiesner

Research output: Contribution to journalReview article

Abstract

Kidney injury is frequently seen in patients with end-stage liver disease from cirrhosis and liver failure. Among selected patients, simultaneous liver kidney (SLK) transplantation provides improved post-transplant graft and patient outcomes compared to liver transplantation (LT) alone. We conducted the review of the existing literature on SLK transplant criteria and outcomes. Since the introduction of the model for end-stage disease (MELD) score in 2002, there has been an increased use of SLK transplantation. The criteria for SLK allocation are relatively homogeneous among patients with end-stage renal disease with cirrhosis and among patients with cirrhosis and chronic kidney disease. However, these are quite heterogeneous among patients with cirrhosis and acute kidney injury (AKI), mainly because of inability to accurately differentiate cause of AKI, especially hepatorenal syndrome versus intrarenal aetiology. Clearly, there is an unmet need of urine biomarkers of tubular injury and/or clinical models to accurately stratify AKI aetiology and to predict renal recovery after LT as basis to best utilize the scarce donor kidney pool. In this regard, it remains to be seen whether recently implemented policies by the organ procurement transplant network can fulfil the goal of saving donor kidneys and optimal allocation of SLK.

Original languageEnglish (US)
Pages (from-to)343-352
Number of pages10
JournalTransplant international : official journal of the European Society for Organ Transplantation
Volume32
Issue number4
DOIs
StatePublished - Apr 1 2019

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Liver Transplantation
Kidney Transplantation
Kidney
Acute Kidney Injury
Transplants
Fibrosis
Liver
Tissue Donors
Hepatorenal Syndrome
End Stage Liver Disease
Tissue and Organ Procurement
Liver Failure
Wounds and Injuries
Chronic Renal Insufficiency
Liver Cirrhosis
Chronic Kidney Failure
Biomarkers
Urine

All Science Journal Classification (ASJC) codes

  • Transplantation

Cite this

Simultaneous liver kidney transplantation. / Singal, Ashwani K.; Ong, Song; Satapathy, Sanjaya; Kamath, Patrick S.; Wiesner, Russel H.

In: Transplant international : official journal of the European Society for Organ Transplantation, Vol. 32, No. 4, 01.04.2019, p. 343-352.

Research output: Contribution to journalReview article

Singal, Ashwani K. ; Ong, Song ; Satapathy, Sanjaya ; Kamath, Patrick S. ; Wiesner, Russel H. / Simultaneous liver kidney transplantation. In: Transplant international : official journal of the European Society for Organ Transplantation. 2019 ; Vol. 32, No. 4. pp. 343-352.
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