TY - JOUR
T1 - Combined liver–kidney transplantation for polycystic liver and kidney disease
T2 - analysis from the United Network for Organ Sharing dataset
AU - Coquillard, Cristin
AU - Berger, Jonathan
AU - Daily, Michael
AU - Shah, Malay
AU - Mei, Xiaonan
AU - Marti, Francesc
AU - Gedaly, Roberto
N1 - Publisher Copyright:
© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
PY - 2016/7/1
Y1 - 2016/7/1
N2 - Background & Aims: The purpose of this study was to evaluate predictors of outcomes in combined liver–kidney transplants for polycystic liver and kidney disease. Methods: We queried the United Network for Organ Sharing dataset for combined liver–kidney transplants performed from 1988 to 2013. Results: Out of 107 patients who had combined liver–kidney transplants for polycystic liver and kidney disease, 84 were women (78.5%) with a mean age of 54.9 ±7.2 years. Kaplan–Meier analysis demonstrated that patients undergoing liver–kidney transplantation for polycystic liver and kidney disease had better survival than patients with polycystic liver disease undergoing liver transplant alone and those undergoing liver–kidney transplantation for other indications. This group had a 1-, 3- and 5-year survival of 91%, 90% and 90%, respectively. Multivariable analysis demonstrated that an indication of polycystic liver and kidney disease for combined liver–kidney transplant (hazard ratio, 0.29; 95% confidence interval, 0.129–0.526; P < 0.001) and Model for End-Stage Liver Disease score (hazard ratio, 1.271; 95% confidence interval, 1.093–1.477; P = 0.002) are independently associated with patient survival. In a propensity score analysis adjusting for age, gender, cold ischaemia time and total bilirubin and excluding hepatitis C, we found that patients transplanted with combined liver–kidney for other indications have similar survival compared with our study group. Conclusions: Combined liver–kidney transplantation for polycystic liver and kidney disease can achieve good outcomes in selected patients. On Cox regression analysis, patients with polycystic liver and kidney disease undergoing liver–kidney transplantation had better survival compared with patients with combined liver–kidney for other indications. After excluding hepatitis C patients, those transplanted for polycystic liver and kidney disease vs other indications had similar survival after combined liver–kidney transplantation. Interestingly, patients in the combined polycystic liver and kidney disease group have significantly better outcomes than patients with polycystic liver disease undergoing liver transplant alone.
AB - Background & Aims: The purpose of this study was to evaluate predictors of outcomes in combined liver–kidney transplants for polycystic liver and kidney disease. Methods: We queried the United Network for Organ Sharing dataset for combined liver–kidney transplants performed from 1988 to 2013. Results: Out of 107 patients who had combined liver–kidney transplants for polycystic liver and kidney disease, 84 were women (78.5%) with a mean age of 54.9 ±7.2 years. Kaplan–Meier analysis demonstrated that patients undergoing liver–kidney transplantation for polycystic liver and kidney disease had better survival than patients with polycystic liver disease undergoing liver transplant alone and those undergoing liver–kidney transplantation for other indications. This group had a 1-, 3- and 5-year survival of 91%, 90% and 90%, respectively. Multivariable analysis demonstrated that an indication of polycystic liver and kidney disease for combined liver–kidney transplant (hazard ratio, 0.29; 95% confidence interval, 0.129–0.526; P < 0.001) and Model for End-Stage Liver Disease score (hazard ratio, 1.271; 95% confidence interval, 1.093–1.477; P = 0.002) are independently associated with patient survival. In a propensity score analysis adjusting for age, gender, cold ischaemia time and total bilirubin and excluding hepatitis C, we found that patients transplanted with combined liver–kidney for other indications have similar survival compared with our study group. Conclusions: Combined liver–kidney transplantation for polycystic liver and kidney disease can achieve good outcomes in selected patients. On Cox regression analysis, patients with polycystic liver and kidney disease undergoing liver–kidney transplantation had better survival compared with patients with combined liver–kidney for other indications. After excluding hepatitis C patients, those transplanted for polycystic liver and kidney disease vs other indications had similar survival after combined liver–kidney transplantation. Interestingly, patients in the combined polycystic liver and kidney disease group have significantly better outcomes than patients with polycystic liver disease undergoing liver transplant alone.
KW - combined liver/kidney transplant
KW - polycystic liver and kidney disease
KW - transplant outcomes
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U2 - 10.1111/liv.13041
DO - 10.1111/liv.13041
M3 - Article
C2 - 26663575
AN - SCOPUS:85027928059
SN - 1478-3223
VL - 36
SP - 1018
EP - 1025
JO - Liver International
JF - Liver International
IS - 7
ER -