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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: National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia.
Central Clinical School, 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: 12-Sep-2020 2020-09-12
Publication information: Transplantation Proceedings 2020; online first: 12 September
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.
DOI: 10.1016/j.transproceed.2020.08.030
PubMed URL: 32933766
Type: Journal Article
Appears in Collections:Journal articles

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