Kidney-alone transplantation in prior SLK candidates: a national registry analysis

Document Type

Article

Publication Date

8-27-2026

Publication Title

Transplant international

Keywords

Humans, Kidney Transplantation, Registries, Female, Liver Transplantation, Male, Graft Survival, Middle Aged, Adult, Kaplan-Meier Estimate, Proportional Hazards Models, Waiting Lists, Treatment Outcome, Kidney Failure, Chronic

Abstract

Outcomes of kidney-alone transplantation (KAT) in former simultaneous liver-kidney (SLK) transplant candidates after liver waitlist delisting are not well defined. Using Scientific Registry of Transplant Recipients (SRTR) data, we identified adult recipients who underwent KAT between 2005 and 2025 after prior SLK listing (RLD-KAT), which was matched 1:5 to primary KAT recipients without liver disease by age, transplant year, and diabetes status. Patient and graft survival were evaluated using the Kaplan-Meier method and multivariable Cox proportional hazards models. We identified 163 RLD-KAT recipients matched to 815 controls. Unadjusted Kaplan-Meier analyses demonstrated lower patient survival in RLD-KAT (p = 0.020), whereas death-censored and overall graft survival were similar (p > 0.05). In multivariable models, death-censored graft survival (HR 0.89; 95% CI 0.51-1.53), overall graft survival (HR 1.00; 95% CI 0.73-1.36), and patient survival (HR 1.07; 95% CI 0.76-1.5) did not differ significantly. Six RLD-KAT recipients (3.7%) subsequently underwent liver transplantation. Kidney-alone transplantation in prior SLK candidates was associated with acceptable patient and graft outcomes and a low incidence of subsequent liver transplantation.

Medical Subject Headings

Humans; Kidney Transplantation; Registries; Female; Liver Transplantation; Male; Graft Survival; Middle Aged; Adult; Kaplan-Meier Estimate; Proportional Hazards Models; Waiting Lists; Treatment Outcome; Kidney Failure, Chronic

PubMed ID

42723848

Volume

39

First Page

16834

Last Page

16834

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