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https://ahro.austin.org.au/austinjspui/handle/1/24973| Title: | Trends and Outcomes in Simultaneous Liver and Kidney Transplantation in Australia and New Zealand. | Austin Authors: | Drak, Douglas;Tangirala, Nishanta;Fink, Michael A ;Adams, Leon A;Fawcett, Jonathan;Jeffrey, Gary P;Byrne, Mandy;McCaughan, Geoffrey;Chadban, Steve;Wyburn, Kate;Wong, Germaine;Lim, Wai H;Gracey, David M | Affiliation: | Central Clinical School, University of Sydney, Sydney, New South Wales, Australia National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia Department of Hepatology, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, Perth, Western Australia, Australia Holdsworth House Medical Practice, Sydney, New South Wales, Australia Department of Renal Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia School of Medicine, The University of Queensland, Brisbane, Australia Princess Alexandra Hospital, Brisbane, Queensland, Australia Liver Injury and Cancer, Centenary Institute, Camperdown, New South Wales, Australia Surgery (University of Melbourne) Nephrology Department, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia Medical School, The University of Western Australia, Perth, Western Australia, Australia Centre for Kidney Research, School, Children's Hospital at Westmead, Westmead, New South Wales, Australia Victorian Liver Transplant Unit |
Issue Date: | Jan-2021 | Date: | 2020-09-12 | Publication information: | Transplantation Proceedings 2021; 53(1): 136-140 | Abstract: | 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. 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. 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. Kidney graft and overall patient survival were similar between patients with preemptive kidney transplant and those who were dialysis dependent. | URI: | https://ahro.austin.org.au/austinjspui/handle/1/24973 | DOI: | 10.1016/j.transproceed.2020.08.030 | Journal: | Transplantation Proceedings | PubMed URL: | 32933766 | Type: | Journal Article |
| Appears in Collections: | Journal articles |
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