Hepatorenal syndrome: Combined liver kidney transplants versus isolated liver transplant

D. Rohan Jeyarajah, Thomas A. Gonwa, Maureen McBride, Giuliano Testa, Osman Abbasoglu, Bo S. Husberg, Marlon F. Levy, Robert M. Goldstein, Goran B. Klintmalm

Research output: Contribution to journalArticle

104 Citations (Scopus)

Abstract

Background. As many as 38% of combined liver-kidney transplant (LKTx) procedures performed nationally may be done for the renal diagnosis of hepatorenal syndrome (HRS). This study was designed to compare the national results with those at our medical center and to determine if combined LKTx provides any benefit over isolated liver transplant (LTx) to HRS patients. Methods. Data on 29 combined LKTx and 79 HRS patients at our center were collected and compared with the national data on 414 LKTx and 2442 patients with serum creatinine >2.0 mg/dl receiving isolated LTx from 1988 to 1995. Results. United Network of Organ Sharing data revealed 5-year patient survival of 62.2% for LKTx recipients and 50.4% for patients with serum creatinine >2.0 mg/dl receiving isolated LTx (P=0.0001). Our center results demonstrated 5-year patient survival of 48.1% for LKTx patients, 67.1% for HRS patients receiving isolated LTx, and 70.1% for patients with serum creatinine >2.0 mg/dl receiving isolated LTx (P not significant comparing all groups). Intensive care unit status and preoperative dialysis rates were similar in those HRS patients who did and those who did not need future KTx. Conclusion. National data would suggest a survival benefit of combined LKTx over isolated LTx for those patients with poor renal function, specifically those with HRS, whereas our center's results suggest otherwise. Unfortunately, we could not identify any preoperative risk factors in the HRS patients, or in the broader group of patients with renal insufficiency at our center, that would indicate the need for future renal transplantation. We believe that HRS patients can be successfully managed with isolated LTx.

Original languageEnglish (US)
Pages (from-to)1760-1765
Number of pages6
JournalTransplantation
Volume64
Issue number12
DOIs
StatePublished - Dec 27 1997
Externally publishedYes

Fingerprint

Hepatorenal Syndrome
Transplants
Kidney
Liver
Creatinine
Survival
Serum
Information Dissemination

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Rohan Jeyarajah, D., Gonwa, T. A., McBride, M., Testa, G., Abbasoglu, O., Husberg, B. S., ... Klintmalm, G. B. (1997). Hepatorenal syndrome: Combined liver kidney transplants versus isolated liver transplant. Transplantation, 64(12), 1760-1765. https://doi.org/10.1097/00007890-199712270-00024

Hepatorenal syndrome : Combined liver kidney transplants versus isolated liver transplant. / Rohan Jeyarajah, D.; Gonwa, Thomas A.; McBride, Maureen; Testa, Giuliano; Abbasoglu, Osman; Husberg, Bo S.; Levy, Marlon F.; Goldstein, Robert M.; Klintmalm, Goran B.

In: Transplantation, Vol. 64, No. 12, 27.12.1997, p. 1760-1765.

Research output: Contribution to journalArticle

Rohan Jeyarajah, D, Gonwa, TA, McBride, M, Testa, G, Abbasoglu, O, Husberg, BS, Levy, MF, Goldstein, RM & Klintmalm, GB 1997, 'Hepatorenal syndrome: Combined liver kidney transplants versus isolated liver transplant', Transplantation, vol. 64, no. 12, pp. 1760-1765. https://doi.org/10.1097/00007890-199712270-00024
Rohan Jeyarajah D, Gonwa TA, McBride M, Testa G, Abbasoglu O, Husberg BS et al. Hepatorenal syndrome: Combined liver kidney transplants versus isolated liver transplant. Transplantation. 1997 Dec 27;64(12):1760-1765. https://doi.org/10.1097/00007890-199712270-00024
Rohan Jeyarajah, D. ; Gonwa, Thomas A. ; McBride, Maureen ; Testa, Giuliano ; Abbasoglu, Osman ; Husberg, Bo S. ; Levy, Marlon F. ; Goldstein, Robert M. ; Klintmalm, Goran B. / Hepatorenal syndrome : Combined liver kidney transplants versus isolated liver transplant. In: Transplantation. 1997 ; Vol. 64, No. 12. pp. 1760-1765.
@article{15db6b90b6144674b5c797e436361579,
title = "Hepatorenal syndrome: Combined liver kidney transplants versus isolated liver transplant",
abstract = "Background. As many as 38{\%} of combined liver-kidney transplant (LKTx) procedures performed nationally may be done for the renal diagnosis of hepatorenal syndrome (HRS). This study was designed to compare the national results with those at our medical center and to determine if combined LKTx provides any benefit over isolated liver transplant (LTx) to HRS patients. Methods. Data on 29 combined LKTx and 79 HRS patients at our center were collected and compared with the national data on 414 LKTx and 2442 patients with serum creatinine >2.0 mg/dl receiving isolated LTx from 1988 to 1995. Results. United Network of Organ Sharing data revealed 5-year patient survival of 62.2{\%} for LKTx recipients and 50.4{\%} for patients with serum creatinine >2.0 mg/dl receiving isolated LTx (P=0.0001). Our center results demonstrated 5-year patient survival of 48.1{\%} for LKTx patients, 67.1{\%} for HRS patients receiving isolated LTx, and 70.1{\%} for patients with serum creatinine >2.0 mg/dl receiving isolated LTx (P not significant comparing all groups). Intensive care unit status and preoperative dialysis rates were similar in those HRS patients who did and those who did not need future KTx. Conclusion. National data would suggest a survival benefit of combined LKTx over isolated LTx for those patients with poor renal function, specifically those with HRS, whereas our center's results suggest otherwise. Unfortunately, we could not identify any preoperative risk factors in the HRS patients, or in the broader group of patients with renal insufficiency at our center, that would indicate the need for future renal transplantation. We believe that HRS patients can be successfully managed with isolated LTx.",
author = "{Rohan Jeyarajah}, D. and Gonwa, {Thomas A.} and Maureen McBride and Giuliano Testa and Osman Abbasoglu and Husberg, {Bo S.} and Levy, {Marlon F.} and Goldstein, {Robert M.} and Klintmalm, {Goran B.}",
year = "1997",
month = "12",
day = "27",
doi = "10.1097/00007890-199712270-00024",
language = "English (US)",
volume = "64",
pages = "1760--1765",
journal = "Transplantation",
issn = "0041-1337",
publisher = "Lippincott Williams and Wilkins",
number = "12",

}

TY - JOUR

T1 - Hepatorenal syndrome

T2 - Combined liver kidney transplants versus isolated liver transplant

AU - Rohan Jeyarajah, D.

AU - Gonwa, Thomas A.

AU - McBride, Maureen

AU - Testa, Giuliano

AU - Abbasoglu, Osman

AU - Husberg, Bo S.

AU - Levy, Marlon F.

AU - Goldstein, Robert M.

AU - Klintmalm, Goran B.

PY - 1997/12/27

Y1 - 1997/12/27

N2 - Background. As many as 38% of combined liver-kidney transplant (LKTx) procedures performed nationally may be done for the renal diagnosis of hepatorenal syndrome (HRS). This study was designed to compare the national results with those at our medical center and to determine if combined LKTx provides any benefit over isolated liver transplant (LTx) to HRS patients. Methods. Data on 29 combined LKTx and 79 HRS patients at our center were collected and compared with the national data on 414 LKTx and 2442 patients with serum creatinine >2.0 mg/dl receiving isolated LTx from 1988 to 1995. Results. United Network of Organ Sharing data revealed 5-year patient survival of 62.2% for LKTx recipients and 50.4% for patients with serum creatinine >2.0 mg/dl receiving isolated LTx (P=0.0001). Our center results demonstrated 5-year patient survival of 48.1% for LKTx patients, 67.1% for HRS patients receiving isolated LTx, and 70.1% for patients with serum creatinine >2.0 mg/dl receiving isolated LTx (P not significant comparing all groups). Intensive care unit status and preoperative dialysis rates were similar in those HRS patients who did and those who did not need future KTx. Conclusion. National data would suggest a survival benefit of combined LKTx over isolated LTx for those patients with poor renal function, specifically those with HRS, whereas our center's results suggest otherwise. Unfortunately, we could not identify any preoperative risk factors in the HRS patients, or in the broader group of patients with renal insufficiency at our center, that would indicate the need for future renal transplantation. We believe that HRS patients can be successfully managed with isolated LTx.

AB - Background. As many as 38% of combined liver-kidney transplant (LKTx) procedures performed nationally may be done for the renal diagnosis of hepatorenal syndrome (HRS). This study was designed to compare the national results with those at our medical center and to determine if combined LKTx provides any benefit over isolated liver transplant (LTx) to HRS patients. Methods. Data on 29 combined LKTx and 79 HRS patients at our center were collected and compared with the national data on 414 LKTx and 2442 patients with serum creatinine >2.0 mg/dl receiving isolated LTx from 1988 to 1995. Results. United Network of Organ Sharing data revealed 5-year patient survival of 62.2% for LKTx recipients and 50.4% for patients with serum creatinine >2.0 mg/dl receiving isolated LTx (P=0.0001). Our center results demonstrated 5-year patient survival of 48.1% for LKTx patients, 67.1% for HRS patients receiving isolated LTx, and 70.1% for patients with serum creatinine >2.0 mg/dl receiving isolated LTx (P not significant comparing all groups). Intensive care unit status and preoperative dialysis rates were similar in those HRS patients who did and those who did not need future KTx. Conclusion. National data would suggest a survival benefit of combined LKTx over isolated LTx for those patients with poor renal function, specifically those with HRS, whereas our center's results suggest otherwise. Unfortunately, we could not identify any preoperative risk factors in the HRS patients, or in the broader group of patients with renal insufficiency at our center, that would indicate the need for future renal transplantation. We believe that HRS patients can be successfully managed with isolated LTx.

UR - http://www.scopus.com/inward/record.url?scp=0345131684&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0345131684&partnerID=8YFLogxK

U2 - 10.1097/00007890-199712270-00024

DO - 10.1097/00007890-199712270-00024

M3 - Article

C2 - 9422417

AN - SCOPUS:0345131684

VL - 64

SP - 1760

EP - 1765

JO - Transplantation

JF - Transplantation

SN - 0041-1337

IS - 12

ER -