Identification of patients best suited for combined liver–kidney transplantation: Part II

Authors

  • Connie L. Davis MD,

    Associate Professor of Medicine, Corresponding author
    1. Department of Medicine, Divisions of Nephrology and Transplantation, University of Washington, Seattle, WA
    • University of Washington, Department of Medicine, Divisions of Nephrology and Transplantation, 1959 NE Pacific St, Seattle, WA 98195. Telephone: 206-598-6079; FAX: 206-598-6706
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  • Thomas A. Gonwa,

    1. Department of Medicine, Divisions of Nephrology and Transplantation, Mayo Clinic Transplant Center, Jacksonville, FL
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  • Alan H. Wilkinson

    1. Department of Medicine, Divisions of Nephrology and Transplantation, University of California at Los Angeles, Los Angeles, CA
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Abstract

Liver-kidney transplantation (LKT) should be reserved for those recipients with primary disease affecting both organs. However, increasing transplant list waiting times have increased the development and duration of acute renal failure before liver transplantation. Furthermore, the need for posttransplant calcineurin inhibitors can render healing from acute renal failure difficult. Because of the increasing requests for and controversy over the topic of a kidney with a liver transplant (OLT) when complete failure of the kidney is not known, the following article will review the impact of renal failure on liver transplant outcome, treatment of peri-OLT renal failure, rejection rates after LKT, survival after LKT, and information on renal histology and progression of disease into the beginnings of an algorithm for making a decision about combined LKT.

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