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Disparity in utilization of combined kidney–liver transplantation in the United States
Article first published online: 26 JUN 2009
DOI: 10.1111/j.1399-0012.2009.01015.x
© 2009 John Wiley & Sons A/S
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How to Cite
Mehta, S. and Leehey, D. (2009), Disparity in utilization of combined kidney–liver transplantation in the United States. Clinical Transplantation, 23: 938–942. doi: 10.1111/j.1399-0012.2009.01015.x
Publication History
- Issue published online: 25 NOV 2009
- Article first published online: 26 JUN 2009
- Accepted for publication 20 May 2009
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Keywords:
- kidney transplantation;
- Model for End-Stage Liver Disease;
- orthotopic liver transplantation;
- United Network of Organ Sharing
Abstract: Background: Orthotopic liver transplantation (OLT) is performed as a definitive treatment of acute and chronic liver failure. The prevalence of acute and chronic kidney diseases is substantially higher in this population secondary to diverse etiologies. Combined kidney–liver transplantation (CKLT) is widely performed in some centers, even though there are no definitive studies which support or contradict this practice.
Methods: We comprehensively reviewed OLT as well as CKLT data from US transplant centers provided by United Network of Organ Sharing (UNOS).
Results: The incidence of CKLT as a percentage of total OLTs performed has been increasing, especially in the post-MELD era (2002 and after). Moreover, there is a great disparity among centers in regard to percentage of CKLTs to total OLTs.
Conclusion: We conclude that there is much difference of opinion among US transplant centers as to indications for CKLT. A more scientific approach to this problem including studies to assess the role of kidney biopsy in determining renal outcome after OLT is needed.