TY - JOUR
T1 - Current status of combined liver-kidney transplantation
AU - Ekser, Burcin
AU - Contreras, Alan G.
AU - Andraus, Wellington
AU - Taner, Timucin
N1 - Publisher Copyright:
© 2020 IJS Publishing Group Ltd
PY - 2020/10
Y1 - 2020/10
N2 - Combined liver-kidney transplantation is a life-saving procedure for patients with end-stage liver disease and underlying chronic kidney disease, or prolonged acute kidney injury. Due to physiologic changes secondary to portal hypertension in patients with end-stage liver disease, kidney injury is common, and combined liver-kidney transplantation accounts for 10% of all the liver transplants performed in the United States. Recently implemented policy in the United States standardizes the medical criteria for eligibility, and introduces a ‘safety net’ for those who are transplanted with a liver graft alone, in order to be able to receive a kidney graft later. Increasing number of combined liver-kidney transplants provides a large cohort of patients to be studied in detail for identification of factors (both donor and recipient-related) associated with better outcomes. Data regarding the safety and efficacy of delaying the kidney transplant part of the combined liver-kidney transplantation, and the immunologic benefits of the multi-organ transplantations including the liver are emerging. Here, we review the most recent analyses, and provide our opinion regarding the best practices in combined liver-kidney transplantation based on the evidence.
AB - Combined liver-kidney transplantation is a life-saving procedure for patients with end-stage liver disease and underlying chronic kidney disease, or prolonged acute kidney injury. Due to physiologic changes secondary to portal hypertension in patients with end-stage liver disease, kidney injury is common, and combined liver-kidney transplantation accounts for 10% of all the liver transplants performed in the United States. Recently implemented policy in the United States standardizes the medical criteria for eligibility, and introduces a ‘safety net’ for those who are transplanted with a liver graft alone, in order to be able to receive a kidney graft later. Increasing number of combined liver-kidney transplants provides a large cohort of patients to be studied in detail for identification of factors (both donor and recipient-related) associated with better outcomes. Data regarding the safety and efficacy of delaying the kidney transplant part of the combined liver-kidney transplantation, and the immunologic benefits of the multi-organ transplantations including the liver are emerging. Here, we review the most recent analyses, and provide our opinion regarding the best practices in combined liver-kidney transplantation based on the evidence.
KW - Combined
KW - Kidney transplantation
KW - Liver and kidney transplantation
KW - Liver transplantation
KW - Outcome
KW - Simultaneous
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U2 - 10.1016/j.ijsu.2020.02.008
DO - 10.1016/j.ijsu.2020.02.008
M3 - Editorial
C2 - 32084547
AN - SCOPUS:85080059769
SN - 1743-9191
VL - 82
SP - 149
EP - 154
JO - International Journal of Surgery
JF - International Journal of Surgery
ER -