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Combined liver-kidney and liver transplantation in patients with renal failure outcomes in the MELD era.

Publication ,  Journal Article
Schmitt, TM; Kumer, SC; Al-Osaimi, A; Shah, N; Argo, CK; Berg, C; Pruett, TL; Northup, PG
Published in: Transpl Int
September 2009

With the implementation of the Model for End-Stage Liver Disease (MELD) scoring system, the number of combined liver-kidney transplants (CLKT) has increased dramatically. The United Network for Organ Sharing (UNOS) dataset was analysed for adult recipients with renal failure for the period between February 2002 and April 2006. This group was subdivided into patients on hemodialysis (HD) and to those not on HD prior to transplantation. All recipients in renal failure (serum creatinine > or =2.5 mg/dl) at the time of transplantation were included. A total of 1397 subjects were in renal failure but not on HD (18% received a CLKT, 82% underwent LT alone). Another 1740 subjects were on HD prior to transplantation (41% received a CLKT while 59% received a LT). In dialysis-dependent recipients, Cox regression analysis demonstrated CLKT had an independent protective effect. In subjects on HD, CLKT had improved survival at 1 year (79.4 vs. 73.7%, P = 0.004). In patients in renal failure without HD, CLKT was not protective. CLKT subjects had a nonsignificant difference in survival as compared with patients who had undergone liver transplantation alone, at 1 year (81.0% vs. 78.8%, P > 0.10). In subjects undergoing CLKT, there was improved survival at 1 year as compared with LT-alone patients on hemodialysis; however, in patients with renal failure, but not on hemodialysis, there was no difference in survival when comparing CLKT to LT-alone.

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Published In

Transpl Int

DOI

EISSN

1432-2277

Publication Date

September 2009

Volume

22

Issue

9

Start / End Page

876 / 883

Location

Switzerland

Related Subject Headings

  • Treatment Outcome
  • Tissue and Organ Procurement
  • Time Factors
  • Surgery
  • Risk
  • Renal Dialysis
  • Regression Analysis
  • Middle Aged
  • Liver Transplantation
  • Kidney Transplantation
 

Citation

APA
Chicago
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Schmitt, T. M., Kumer, S. C., Al-Osaimi, A., Shah, N., Argo, C. K., Berg, C., … Northup, P. G. (2009). Combined liver-kidney and liver transplantation in patients with renal failure outcomes in the MELD era. Transpl Int, 22(9), 876–883. https://doi.org/10.1111/j.1432-2277.2009.00887.x
Schmitt, Timothy M., Sean C. Kumer, Abdullah Al-Osaimi, Neeral Shah, Curtis K. Argo, Carl Berg, Timothy L. Pruett, and Patrick G. Northup. “Combined liver-kidney and liver transplantation in patients with renal failure outcomes in the MELD era.Transpl Int 22, no. 9 (September 2009): 876–83. https://doi.org/10.1111/j.1432-2277.2009.00887.x.
Schmitt TM, Kumer SC, Al-Osaimi A, Shah N, Argo CK, Berg C, et al. Combined liver-kidney and liver transplantation in patients with renal failure outcomes in the MELD era. Transpl Int. 2009 Sep;22(9):876–83.
Schmitt, Timothy M., et al. “Combined liver-kidney and liver transplantation in patients with renal failure outcomes in the MELD era.Transpl Int, vol. 22, no. 9, Sept. 2009, pp. 876–83. Pubmed, doi:10.1111/j.1432-2277.2009.00887.x.
Schmitt TM, Kumer SC, Al-Osaimi A, Shah N, Argo CK, Berg C, Pruett TL, Northup PG. Combined liver-kidney and liver transplantation in patients with renal failure outcomes in the MELD era. Transpl Int. 2009 Sep;22(9):876–883.
Journal cover image

Published In

Transpl Int

DOI

EISSN

1432-2277

Publication Date

September 2009

Volume

22

Issue

9

Start / End Page

876 / 883

Location

Switzerland

Related Subject Headings

  • Treatment Outcome
  • Tissue and Organ Procurement
  • Time Factors
  • Surgery
  • Risk
  • Renal Dialysis
  • Regression Analysis
  • Middle Aged
  • Liver Transplantation
  • Kidney Transplantation