Living Donor Liver Transplantation Alone Is Not Inferior to Combined Kidney Liver Transplant for Cirrhotic Patients With Chronic Kidney Disease
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作者:
Verma, Sapana
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机构:
Max Healthcare, Ctr Liver & Biliary Sci, New Delhi, India
Apollo Hosp, Apollo Inst Liver Sci, Liver Transplant Unit, Chennai, India
Max Healthcare, Ctr Liver & Biliary Sci, Saket 1,Press Enclave Rd, New Delhi 110017, IndiaMax Healthcare, Ctr Liver & Biliary Sci, New Delhi, India
Verma, Sapana
[1
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Naganathan, Selva Kumar
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机构:
Max Healthcare, Ctr Liver & Biliary Sci, New Delhi, India
Apollo Hosp, Apollo Inst Liver Sci, Liver Transplant Unit, Chennai, IndiaMax Healthcare, Ctr Liver & Biliary Sci, New Delhi, India
Background. Chronic kidney disease (CKD) is common in patients with chronic liver disease (CLD) as is acute kidney injury (AKI). The differentiation between CKD vs AKI is often difficult and sometimes the both may coexist. A combined kidney-liver transplant (CKLT) may result in a kidney transplant in patients whose renal function is likely to recover or at least who have stable renal function post-transplant. We retrospectively enrolled 2742 patients who underwent living donor liver transplant at our center from 2007 to 2019. Methods. This audit was carried out in liver transplant recipients with CKD 3 to 5 who underwent either liver transplant alone (LTA) or CKLT to look at outcomes and long-term evolution of renal function. Forty-seven patients met the medical eligibility criteria for CKLT. Of the 47 patients, 25 underwent LTA and the rest 22 underwent CKLT. The diagnosis of CKD was made according to the Kidney Disease: Improving Global Outcomes classification. Results. Preoperative renal function parameters were comparable between the 2 groups. However, CKLT patients had significantly lower glomerular filtration rates (P = .007) and higher proteinuria (P = .01). Postoperatively, renal function, and comorbidities were comparable between the 2 groups. Survival was similar at 1, 3, and 12 months, respectively (log-rank; P = .84, = .81, and = .96, respectively). At the end of the study period, 57% of patients who survived in LTA groups had stabilized renal function (Creatinine = 1.8 +/- 0.6 mg/dL). Conclusions. Liver transplant alone is not inferior to CKLT in living donor situations. Renal dysfunction is stabilized in the long term whereas long-term dialysis may be carried out in others. Living donor liver transplantation alone is not inferior to CKLT for cirrhotic patients with CKD.
机构:
Univ Wisconsin, Dept Surg, Div Transplantat, Madison, WI USA
Sisli Mem Hosp, Organ Transplantat Ctr, Istanbul, TurkeyUniv Wisconsin, Dept Surg, Div Transplantat, Madison, WI USA
Ahmed, E.
Yankol, Y.
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Univ Wisconsin, Dept Surg, Div Transplantat, Madison, WI USAUniv Wisconsin, Dept Surg, Div Transplantat, Madison, WI USA
Yankol, Y.
Rizzari, M.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Wisconsin, Dept Surg, Div Transplantat, Madison, WI USAUniv Wisconsin, Dept Surg, Div Transplantat, Madison, WI USA
Rizzari, M.
Fernandez, L.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Wisconsin, Dept Surg, Div Transplantat, Madison, WI USAUniv Wisconsin, Dept Surg, Div Transplantat, Madison, WI USA
Fernandez, L.
Leverson, G.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Wisconsin, Dept Surg, Div Transplantat, Madison, WI USAUniv Wisconsin, Dept Surg, Div Transplantat, Madison, WI USA
Leverson, G.
Foley, D.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Wisconsin, Dept Surg, Div Transplantat, Madison, WI USAUniv Wisconsin, Dept Surg, Div Transplantat, Madison, WI USA
Foley, D.
Mezrich, J.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Wisconsin, Dept Surg, Div Transplantat, Madison, WI USAUniv Wisconsin, Dept Surg, Div Transplantat, Madison, WI USA
Mezrich, J.
Kanmaz, T.
论文数: 0引用数: 0
h-index: 0
机构:
Sisli Mem Hosp, Organ Transplantat Ctr, Istanbul, TurkeyUniv Wisconsin, Dept Surg, Div Transplantat, Madison, WI USA
Kanmaz, T.
D'Alessandro, A.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Wisconsin, Dept Surg, Div Transplantat, Madison, WI USAUniv Wisconsin, Dept Surg, Div Transplantat, Madison, WI USA
D'Alessandro, A.
Acarli, K.
论文数: 0引用数: 0
h-index: 0
机构:
Sisli Mem Hosp, Organ Transplantat Ctr, Istanbul, TurkeyUniv Wisconsin, Dept Surg, Div Transplantat, Madison, WI USA
Acarli, K.
Kalayoglu, M.
论文数: 0引用数: 0
h-index: 0
机构:
Sisli Mem Hosp, Organ Transplantat Ctr, Istanbul, TurkeyUniv Wisconsin, Dept Surg, Div Transplantat, Madison, WI USA
机构:
Univ Wisconsin, Dept Surg, Div Transplantat, Madison, WI USAUniv Wisconsin, Dept Surg, Div Transplantat, Madison, WI USA
Ahmed, E.
Yankol, Y.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Wisconsin, Dept Surg, Div Transplantat, Madison, WI USA
Sisli Mem Hosp, Organ Transplantat Ctr, Istanbul, TurkeyUniv Wisconsin, Dept Surg, Div Transplantat, Madison, WI USA
Yankol, Y.
Rizzari, M.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Wisconsin, Dept Surg, Div Transplantat, Madison, WI USAUniv Wisconsin, Dept Surg, Div Transplantat, Madison, WI USA
Rizzari, M.
Fernandez, L.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Wisconsin, Dept Surg, Div Transplantat, Madison, WI USAUniv Wisconsin, Dept Surg, Div Transplantat, Madison, WI USA
Fernandez, L.
Leverson, G.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Wisconsin, Dept Surg, Div Transplantat, Madison, WI USAUniv Wisconsin, Dept Surg, Div Transplantat, Madison, WI USA
Leverson, G.
Foley, D.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Wisconsin, Dept Surg, Div Transplantat, Madison, WI USAUniv Wisconsin, Dept Surg, Div Transplantat, Madison, WI USA
Foley, D.
Mezrich, J.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Wisconsin, Dept Surg, Div Transplantat, Madison, WI USAUniv Wisconsin, Dept Surg, Div Transplantat, Madison, WI USA
Mezrich, J.
Kanmaz, T.
论文数: 0引用数: 0
h-index: 0
机构:
Sisli Mem Hosp, Organ Transplantat Ctr, Istanbul, TurkeyUniv Wisconsin, Dept Surg, Div Transplantat, Madison, WI USA
Kanmaz, T.
D'Alessandro, A.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Wisconsin, Dept Surg, Div Transplantat, Madison, WI USAUniv Wisconsin, Dept Surg, Div Transplantat, Madison, WI USA
D'Alessandro, A.
Acarli, K.
论文数: 0引用数: 0
h-index: 0
机构:
Sisli Mem Hosp, Organ Transplantat Ctr, Istanbul, TurkeyUniv Wisconsin, Dept Surg, Div Transplantat, Madison, WI USA
Acarli, K.
Kalayoglu, M.
论文数: 0引用数: 0
h-index: 0
机构:
Sisli Mem Hosp, Organ Transplantat Ctr, Istanbul, TurkeyUniv Wisconsin, Dept Surg, Div Transplantat, Madison, WI USA
机构:
Univ Calif San Diego, Med Ctr, Dept Surg, Div Transplantat, San Diego, CA 92103 USAUniv Calif San Diego, Med Ctr, Dept Surg, Div Transplantat, San Diego, CA 92103 USA
Halldorson, J.
Kazi, Z.
论文数: 0引用数: 0
h-index: 0
机构:
Duke Univ, Med Ctr, Div Med Genet, Durham, NC 27710 USAUniv Calif San Diego, Med Ctr, Dept Surg, Div Transplantat, San Diego, CA 92103 USA
Kazi, Z.
Mekeel, K.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Calif San Diego, Med Ctr, Dept Surg, Div Transplantat, San Diego, CA 92103 USAUniv Calif San Diego, Med Ctr, Dept Surg, Div Transplantat, San Diego, CA 92103 USA
Mekeel, K.
Kuo, A.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Calif San Diego, Dept Med, Div Gastroenterol, San Diego, CA 92103 USAUniv Calif San Diego, Med Ctr, Dept Surg, Div Transplantat, San Diego, CA 92103 USA
Kuo, A.
Hassanein, T.
论文数: 0引用数: 0
h-index: 0
机构:
Southern Calif Gland Liver Ctr, Santa Monica, CA 92118 USAUniv Calif San Diego, Med Ctr, Dept Surg, Div Transplantat, San Diego, CA 92103 USA
Hassanein, T.
Loomba, R.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Calif San Diego, Dept Med, Div Gastroenterol, San Diego, CA 92103 USAUniv Calif San Diego, Med Ctr, Dept Surg, Div Transplantat, San Diego, CA 92103 USA
Loomba, R.
Austin, S.
论文数: 0引用数: 0
h-index: 0
机构:
Duke Univ, Med Ctr, Div Med Genet, Durham, NC 27710 USAUniv Calif San Diego, Med Ctr, Dept Surg, Div Transplantat, San Diego, CA 92103 USA
Austin, S.
Valasek, M. A.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Calif San Diego, Med Ctr, Dept Pathol, San Diego, CA 92103 USAUniv Calif San Diego, Med Ctr, Dept Surg, Div Transplantat, San Diego, CA 92103 USA
Valasek, M. A.
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机构:
Kishnani, P.
Hemming, A. W.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Calif San Diego, Med Ctr, Dept Surg, Div Transplantat, San Diego, CA 92103 USAUniv Calif San Diego, Med Ctr, Dept Surg, Div Transplantat, San Diego, CA 92103 USA
机构:
Henry Ford Hosp, Transplant & Hepatobiliary Surg, 2799 W Grand Blvd,CFP-2, Detroit, MI 48202 USAHenry Ford Hosp, Transplant & Hepatobiliary Surg, 2799 W Grand Blvd,CFP-2, Detroit, MI 48202 USA
Nagai, Shunji
Safwan, Mohamed
论文数: 0引用数: 0
h-index: 0
机构:
Henry Ford Hosp, Transplant & Hepatobiliary Surg, 2799 W Grand Blvd,CFP-2, Detroit, MI 48202 USAHenry Ford Hosp, Transplant & Hepatobiliary Surg, 2799 W Grand Blvd,CFP-2, Detroit, MI 48202 USA
Safwan, Mohamed
Collins, Kelly
论文数: 0引用数: 0
h-index: 0
机构:
Henry Ford Hosp, Transplant & Hepatobiliary Surg, 2799 W Grand Blvd,CFP-2, Detroit, MI 48202 USAHenry Ford Hosp, Transplant & Hepatobiliary Surg, 2799 W Grand Blvd,CFP-2, Detroit, MI 48202 USA
Collins, Kelly
Schilke, Randolph E.
论文数: 0引用数: 0
h-index: 0
机构:
Henry Ford Hosp, Transplant & Hepatobiliary Surg, 2799 W Grand Blvd,CFP-2, Detroit, MI 48202 USAHenry Ford Hosp, Transplant & Hepatobiliary Surg, 2799 W Grand Blvd,CFP-2, Detroit, MI 48202 USA
Schilke, Randolph E.
Rizzari, Michael
论文数: 0引用数: 0
h-index: 0
机构:
Henry Ford Hosp, Transplant & Hepatobiliary Surg, 2799 W Grand Blvd,CFP-2, Detroit, MI 48202 USAHenry Ford Hosp, Transplant & Hepatobiliary Surg, 2799 W Grand Blvd,CFP-2, Detroit, MI 48202 USA
Rizzari, Michael
Moonka, Dilip
论文数: 0引用数: 0
h-index: 0
机构:
Henry Ford Hosp, Gastroenterol, Detroit, MI 48202 USAHenry Ford Hosp, Transplant & Hepatobiliary Surg, 2799 W Grand Blvd,CFP-2, Detroit, MI 48202 USA
Moonka, Dilip
Brown, Kimberly
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h-index: 0
机构:
Henry Ford Hosp, Gastroenterol, Detroit, MI 48202 USAHenry Ford Hosp, Transplant & Hepatobiliary Surg, 2799 W Grand Blvd,CFP-2, Detroit, MI 48202 USA
Brown, Kimberly
Patel, Anita
论文数: 0引用数: 0
h-index: 0
机构:
Henry Ford Hosp, Nephrol, Detroit, MI 48202 USAHenry Ford Hosp, Transplant & Hepatobiliary Surg, 2799 W Grand Blvd,CFP-2, Detroit, MI 48202 USA
Patel, Anita
Yoshida, Atsushi
论文数: 0引用数: 0
h-index: 0
机构:
Henry Ford Hosp, Transplant & Hepatobiliary Surg, 2799 W Grand Blvd,CFP-2, Detroit, MI 48202 USAHenry Ford Hosp, Transplant & Hepatobiliary Surg, 2799 W Grand Blvd,CFP-2, Detroit, MI 48202 USA
Yoshida, Atsushi
Abouljoud, Marwan
论文数: 0引用数: 0
h-index: 0
机构:
Henry Ford Hosp, Transplant & Hepatobiliary Surg, 2799 W Grand Blvd,CFP-2, Detroit, MI 48202 USAHenry Ford Hosp, Transplant & Hepatobiliary Surg, 2799 W Grand Blvd,CFP-2, Detroit, MI 48202 USA