Trends and Outcomes in Simultaneous Liver and Kidney Transplantation in Australia and New Zealand

Trends and Outcomes in Simultaneous Liver and Kidney Transplantation in Australia and New Zealand.

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Item Type: Article
Status: Published
Official URL: https://doi.org/10.1016/j.transproceed.2020.08.030
Journal or Publication Title: Transplantation Proceedings
Volume: 53
Number: 1
Page Range: pp. 136-140
Date: 2021
Divisions: Liver Injury and Cancer
Depositing User: General Admin
Identification Number: 10.1016/j.transproceed.2020.08.030
ISSN: 00411345
Date Deposited: 10 Jun 2021 06:42
Abstract:

Aim: Rates of simultaneous liver and kidney transplantation (SLKT) have increased, but indications for SLKT remain poorly defined. Additional data are needed to determine which patients benefit from SLKT to best direct use of scarce donor kidneys.

Methods: Data were extracted from the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) database for all SLKT performed until the end of 2017. Patients were divided by pretransplant dialysis status into no dialysis before SLKT (preemptive kidney transplant) and any dialysis before SLKT (nonpreemptive). Baseline characteristics and outcomes were compared.

Results: Between 1989 and 2017, inclusive, 84 SLKT procedures were performed in Australia, of which 24% were preemptive. Preemptive and nonpreemptive SLKT recipients did not significantly differ in age (P = .267), sex (P = .526), or ethnicity (P = .870). Over a median follow-up time of 4.5 years, preemptively transplanted patients had a statistically equivalent risk of kidney graft failure (hazard ratio (HR) 1.83, 95% confidence interval [CI]: 0.36-12.86, P = .474) and all-cause mortality (HR 1.69, 95% CI: 0.51-5.6, P = .226) compared to nonpreemptive patients. Overall, 1- and 5-year survival rates for all SLKTs were 92% (95% CI: 86-96) and 60% (95% CI: 45-75), respectively.

Conclusion: Kidney graft and overall patient survival were similar between patients with preemptive kidney transplant and those who were dialysis dependent.

Copyright © 2020 Elsevier Inc. All rights reserved.

Creators:
Creators
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Drak, Douglas
UNSPECIFIED
Tangirala, Nishanta
UNSPECIFIED
Fink, Michael
UNSPECIFIED
Adams, Leon A.
UNSPECIFIED
Fawcett, Jonathan
UNSPECIFIED
Jeffrey, Gary P.
UNSPECIFIED
Byrne, Mandy
UNSPECIFIED
McCaughan, Geoffrey
UNSPECIFIED
Chadban, Steve
UNSPECIFIED
Wyburn, Kate
UNSPECIFIED
Wong, Germaine
UNSPECIFIED
Lim, Wai H.
UNSPECIFIED
Gracey, David M.
UNSPECIFIED
Last Modified: 10 Jun 2021 06:42
URI: https://eprints.centenary.org.au/id/eprint/1047

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