Journal of Clinical and Translational Hepatology

Journal of Clinical and Translational Hepatology

Sunday, 12 / 16 / 2018

Articles

Refining the Role of Simultaneous Liver Kidney Transplantation

REVIEW ARTICLE

Refining the Role of Simultaneous Liver Kidney Transplantation

Sabiha M. Hussain and Kalathil K. Sureshkumar*

Division of Nephrology and Hypertension, Department of Medicine, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PA, USA

*Correspondence to: Kalathil K. Sureshkumar, Division of Nephrology and Hypertension, Department of Medicine, Allegheny General Hospital, 320 East North Avenue, Pittsburgh, PA 15212, USA. Tel: +1-412-359-3319, Fax: +1-412-359-4136, E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Journal of Clinical and Translational Hepatology 2018;6(3):289-295 DOI: 10.14218/JCTH.2017.00065
Received: October 12, 2017 Accepted: March 22, 2018 Published online: June 8, 2018

Abstract

Adoption of the model for end-stage liver disease score by Organ Procurement and Transplant Network (OPTN) deceased donor liver allocation policy in 2002 has led to an increase in the number of simultaneous liver kidney (SLK) transplantation. Since kidney function recovery following liver transplantation is difficult to predict, allocation of the kidney for SLK transplantation thus far has not been based on much rationale and evidence. Lack of OPTN policy towards SLK organ allocation has resulted in great variations among transplant centers regarding SLK transplantation. Increasing use of kidneys towards SLK transplantation diverts deceased donor kidneys away from candidates awaiting kidney-alone transplantation. Recently OPTN/United Network of Organ Sharing has implemented medical eligibility criteria for adult SLK transplantation which also includes a concept of safety net. Implementation of the new policy is a move in a positive direction, providing consistency in our practice and evidence-based guidelines in selecting candidates for SLK transplantation. This policy needs to be monitored prospectively and modified based on new data that will emerge over time. This review outlines the literature on SLK transplantation and efforts towards developing rational policy on SLK organ allocation.

Keywords

Liver kidney transplantation, Graft survival, MELD score, Creatinine, GFR

 

 

 

Journal of Clinical and Translational Hepatology 2018 vol. 6, 289-295 [ Html ] [ PDF Full-text ]

 

© The Authors 2018. This article is published under the terms of the Creative Commons Attribution-Noncommercial License (CC BY-NC 4.0), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license.

 

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