Pathophysiology of renal disease associated with liver disorders: Implications for liver transplantation. Part I

Connie L. Davis, Thomas A. Gonwa, Alan H. Wilkinson

Research output: Contribution to journalArticle

101 Citations (Scopus)

Abstract

Renal and hepatic function are often intertwined through both the existence of associated primary organ diseases and hemodynamic interrelationships. This connection occasionally results in the chronic failure of both organs, necessitating combined liver-kidney transplantation (LKT). Since 1988, more than 850 patients in the United States have received such transplants, with patient survival somewhat less than that for patients receiving either organ alone. Patients with renal failure caused by acute injury or hepatorenal syndrome have classically not been included as candidates for combined transplantation because of the reversibility of renal dysfunction after liver transplantation. However, the rate and duration of renal failure before liver transplantation is increasing in association with prolonged waiting list times. Thus, the issue of acquired permanent renal damage in the setting of hepatic failure continues to confront the transplant community. The following article and its sequel (Part II, to be published in vol 8, no 3 of this journal) attempt to review the problem of primary and secondary renal disease in patients with end-stage liver disease, elements involved in renal disease progression and recovery, the impact of renal disease on liver transplant outcome, and results of combined LKT; outline the steps in the pretransplantation renal evaluation; and provide the beginnings of an algorithm for making the decision for combined LKT.

Original languageEnglish (US)
Pages (from-to)91-109
Number of pages19
JournalLiver Transplantation
Volume8
Issue number2
DOIs
StatePublished - 2002

Fingerprint

Liver Transplantation
Kidney
Liver
Kidney Transplantation
Transplants
Hepatorenal Syndrome
End Stage Liver Disease
Waiting Lists
Liver Failure
Acute Kidney Injury
Renal Insufficiency
Disease Progression
Liver Diseases
Decision Making
Transplantation
Hemodynamics
Survival
Wounds and Injuries

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Pathophysiology of renal disease associated with liver disorders : Implications for liver transplantation. Part I. / Davis, Connie L.; Gonwa, Thomas A.; Wilkinson, Alan H.

In: Liver Transplantation, Vol. 8, No. 2, 2002, p. 91-109.

Research output: Contribution to journalArticle

Davis, Connie L. ; Gonwa, Thomas A. ; Wilkinson, Alan H. / Pathophysiology of renal disease associated with liver disorders : Implications for liver transplantation. Part I. In: Liver Transplantation. 2002 ; Vol. 8, No. 2. pp. 91-109.
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