Continued influence of preoperative renal function on outcome of orthotopic liver transplant (OLTX) in the US: Where will MELD lead us?

T. A. Gonwa, M. A. McBride, K. Anderson, Martin Mai, H. Wadei, N. Ahsan

Research output: Contribution to journalArticle

232 Citations (Scopus)

Abstract

Renal function is a component of the Model for End Stage Liver Disease (MELD), We queried the 1999-2004 OPTN/UNOS database to determine whether preoperative renal function remained an important determinant of survival in primary deceased donor liver transplant alone patients (DDLTA) or primary combined kidney liver transplant patients (KLTX). We examined preoperative creatinine, renal replacement therapy (RRT), incidence of KLTX, and patient survival in the 34 months before and after introduction of MELD and performed a multivariate Cox regression analysis of time to death. Preoperative renal function is an independent predictor of survival in DDLTA but not in KLTX. When compared to DDLTA with a preoperative serum creatinine of 0-0.99 mg/dL, patients with serum creatinine from 1-1.99 mg/dL, >2.0 mg/dL, those requiring RRT, and those receiving KLTX had a relative risk of death following transplant of 1.11, 1.58, 1.77, and 1.44 respectively. KLTX requiring RRT had better survival than DDLTA requiring RRT. Since introduction of MELD, KLTX, preoperative creatinine, and number of patients requiring preoperative RRT have increased. Despite this, patient survival following orthotopic liver transplant (OLTX) in the 34 months after introduction of MELD is not different than prior to introduction of MELD.

Original languageEnglish (US)
Pages (from-to)2651-2659
Number of pages9
JournalAmerican Journal of Transplantation
Volume6
Issue number11
DOIs
StatePublished - Nov 2006

Fingerprint

End Stage Liver Disease
Transplants
Kidney
Renal Replacement Therapy
Liver
Creatinine
Survival
Tissue Donors
Serum
Regression Analysis
Databases
Incidence

Keywords

  • Combined kidney liver transplant
  • Liver transplant
  • MELD
  • Renal function

ASJC Scopus subject areas

  • Immunology

Cite this

Continued influence of preoperative renal function on outcome of orthotopic liver transplant (OLTX) in the US : Where will MELD lead us? / Gonwa, T. A.; McBride, M. A.; Anderson, K.; Mai, Martin; Wadei, H.; Ahsan, N.

In: American Journal of Transplantation, Vol. 6, No. 11, 11.2006, p. 2651-2659.

Research output: Contribution to journalArticle

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