Simultaneous Liver-Kidney Transplantation: Impact on Liver Transplant Patients and the Kidney Transplant Waiting List

Clifford D. Miles, Scott Westphal, Ann Marie Liapakis, Richard Formica

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Purpose: The number of simultaneous liver-kidney transplants (SLKT) performed in the USA has been rising. The Organ Procurement and Transplantation Network implemented a new policy governing SLKT that specifies eligibility criteria for candidates to receive a kidney with a liver, and creates a kidney waitlist “safety net” for liver recipients with persistent renal failure after transplant. This review explores potential impacts for liver patients and the kidney waitlist. Recent Findings: Factors that have contributed to the rise in SLKT including Model for End-stage Liver Disease (MELD)-based allocation, regional sharing for high MELD candidates, and the rising incidence of non-alcoholic steatohepatitis will continue to increase the number of liver transplant candidates with concurrent renal insufficiency. The effect of center behavior based on the new policy is harder to predict, given wide historic variability in SLKT practice. Summary: Continued increase in combined liver/kidney failure is likely, and SLKT and kidney after liver transplant may both increase. Impact of the new policy should be carefully monitored, but influences beyond the policy need to be accounted for.

Original languageEnglish (US)
JournalCurrent Transplantation Reports
Volume5
Issue number1
DOIs
StatePublished - Mar 1 2018

Keywords

  • Multi-organ transplant
  • Organ allocation policy
  • Simultaneous liver-kidney transplantation

ASJC Scopus subject areas

  • Immunology
  • Hepatology
  • Nephrology
  • Surgery
  • Transplantation

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