Trends and Outcomes in Simultaneous Liver and Kidney Transplantation in Australia and New Zealand

被引：1

作者：

Drak, Douglas ^{[1
]}

Tangirala, Nishanta ^{[2
]}

Fink, Michael ^{[3
]}

Adams, Leon A. ^{[4
,5
]}

Fawcett, Jonathan ^{[6
,7
]}

Jeffrey, Gary P. ^{[4
,5
]}

Byrne, Mandy ^{[8
]}

McCaughan, Geoffrey ^{[9
,10
]}

Chadban, Steve ^{[2
,9
]}

Wyburn, Kate ^{[2
,9
]}

Wong, Germaine ^{[11
]}

Lim, Wai H. ^{[4
,12
]}

Gracey, David M. ^{[2
,9
,13
]}

机构：

[1] Univ Sydney, Natl Hlth & Med Res Council Clin Trials Ctr, Sydney, NSW, Australia

[2] Royal Prince Alfred Hosp, Nephrol Dept, Sydney, NSW, Australia

[3] Univ Melbourne, Austin Hlth, Dept Surg, Melbourne, Vic, Australia

[4] Univ Western Australia, Med Sch, Perth, WA, Australia

[5] Sir Charles Gairdner Hosp, Dept Hepatol, Hosp Ave, Perth, WA, Australia

[6] Princess Alexandra Hosp, Brisbane, Qld, Australia

[7] Univ Queensland, Sch Med, Brisbane, Qld, Australia

[8] Victorian Liver Transplant Unit, Heidelberg, Vic, Australia

[9] Univ Sydney, Cent Clin Sch, Sydney, NSW, Australia

[10] Centenary Inst, Liver Injury & Canc, Camperdown, NSW, Australia

[11] Childrens Hosp Westmead, Ctr Kidney Res, Westmead, NSW, Australia

[12] Sir Charles Gairdner Hosp, Dept Renal Med, Nedlands, WA, Australia

[13] Holdsworth House Med Practice, Sydney, NSW, Australia

来源：

TRANSPLANTATION PROCEEDINGS | 2021年 / 53卷 / 01期

关键词：

UNITED NETWORK; SURVIVAL; CREATININE; BENEFIT;

D O I：

10.1016/j.transproceed.2020.08.030

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Aim. Rates of simultaneous liver and kidney transplantation (SLKT) have increased, but indications for SLKT remain poorly defined. Additional data are needed to determine which patients benefit from SLKT to best direct use of scarce donor kidneys. Methods. Data were extracted from the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) database for all SLKT performed until the end of 2017. Patients were divided by pretransplant dialysis status into no dialysis before SLKT (preemptive kidney transplant) and any dialysis before SLKT (nonpreemptive). Baseline characteristics and outcomes were compared. Results. Between 1989 and 2017, inclusive, 84 SLKT procedures were performed in Australia, of which 24% were preemptive. Preemptive and nonpreemptive SLKT recipients did not significantly differ in age (P = .267), sex (P = .526), or ethnicity (P = .870). Over a median follow-up time of 4.5 years, preemptively transplanted patients had a statistically equivalent risk of kidney graft failure (hazard ratio (HR) 1.83, 95% confidence interval [CI]: 0.36-12.86, P = .474) and all-cause mortality (HR 1.69, 95% CI: 0.51-5.6, P = .226) compared to nonpreemptive patients. Overall, 1- and 5-year survival rates for all SLKTs were 92% (95% CI: 86-96) and 60% (95% CI: 45-75), respectively. Conclusion. Kidney graft and overall patient survival were similar between patients with preemptive kidney transplant and those who were dialysis dependent.

引用

页码：136 / 140

页数：5

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