Temporal Trends and Evolving Outcomes After Simultaneous Liver-Kidney Transplantation: Results from the US SLKT Consortium.

Journal Article (Journal Article;Multicenter Study)

We aimed to understand the contemporary changes in the characteristics and the determinants of outcomes among simultaneous liver-kidney transplantation (SLKT) recipients at 6 liver transplantation centers in the United States. We retrospectively enrolled SLKT recipients between 2002 and 2017 in the US Multicenter SLKT Consortium. We analyzed time-related trends in recipient characteristics and outcomes with linear regression and nonparametric methods. Clustered Cox regression determined the factors associated with 1-year and overall survival. We enrolled 572 patients. We found significant changes in the clinical characteristics of SLKT recipients: as compared with 2002, recipients in 2017 were older (59 versus 52 years; P < 0.001) and more likely to have chronic kidney disease (71% versus 33%; P < 0.001). There was a marked improvement in 1-year survival during the study period: 89% in 2002 versus 96% in 2017 (P < 0.001). We found that the drivers of 1-year mortality were SLKT year, hemodialysis at listing, donor distance, and delayed kidney allograft function. The drivers of overall mortality were an indication of acute kidney dysfunction, body mass index, hypertension, creatinine at SLKT, ventilation at SLKT, and donor quality. In this contemporary cohort of SLKT recipients, we highlight changes in the clinical characteristics of recipients. Further, we identify the determinants of 1-year and overall survival to highlight the variables that require the greatest attention to optimize outcomes.

Full Text

Duke Authors

Cited Authors

  • Cullaro, G; Sharma, P; Jo, J; Rassiwala, J; VanWagner, LB; Wong, R; Lai, JC; Magee, J; Schluger, A; Barman, P; Patel, YA; Walter, K; Biggins, SW; Verna, EC

Published Date

  • November 2021

Published In

Volume / Issue

  • 27 / 11

Start / End Page

  • 1613 - 1622

PubMed ID

  • 34265161

Pubmed Central ID

  • PMC8982673

Electronic International Standard Serial Number (EISSN)

  • 1527-6473

Digital Object Identifier (DOI)

  • 10.1002/lt.26232


  • eng

Conference Location

  • United States