Outcomes of Simultaneous Liver and Kidney Transplant vs. Liver Transplant Alone: Insights from a Midwest Transplant Center

Document Type

Conference Proceeding

Publication Date

8-1-2025

Publication Title

Am J Transplant

Abstract

Purpose: We aimed to evaluate long-term renal and survival outcomes in patients with chronic kidney disease (CKD) undergoing liver transplantation alone (LTA) versus simultaneous simultaneous liver and kidney transplant (SLK). Methods: A retrospective study included adult CKD patients (GFR <60 for ≥3 months pre-transplant) who underwent LTA or SLK at our center (2015-2022). Data collected covered demographics, comorbidities, liver disease, and dialysis status. The primary outcome was GFR at 3 months pre-transplant and 3, 6, 12, and 36 months post-transplant. Secondary outcomes included LOS, 1-year readmission, rejection, retransplantation, and mortality at 1, 3, and 5 years. Results: Our study included 231 patients: 67 underwent SLK, and 164 received LTA. Patient characteristics are in Table 1. Cirrhosis was the primary transplant indication in 193 patients (97%), mostly due to alcohol. The SLK group had higher creatinine on transplant day, pre-transplant HRS, and significantly lower pre-transplant GFR (22.1 ± 11.7 vs. 47.8 ± 15.6, p < 0.001). Both groups showed GFR improvement (p < 0.01), but SLK had consistently higher post-transplant GFR, especially at 3 months (65.8 ± 24.5 vs. 52.3 ± 19.0, p < 0.01) (Figure 1). GFR decline was greater in LTA (p < 0.01). Mortality (28% vs. 20%, p = 0.14) and LOS (13 days, p = 0.3) were similar. Pre- or emergent post-transplant dialysis prolonged hospital stay (p < 0.01, p < 0.027). No significant differences were found in readmission (68% SLK vs. 63% LTA, p = 0.4) or re-transplantation (6.7% vs. 9.4%, p = 0.9). Graft rejection was higher in SLK (23% vs. 17%) but not significant (p = 0.3). Conclusions: Our study shows that SLK transplant provided better long-term renal preservation in patients with CKD. Mortality,LOS,readmission, and re-transplant rates were similar between groups,suggesting that SLK does not significantly increase perioperative risk or resource use. [Formula presented] CITATION INFORMATION: Abusuliman M., Kadouh A., Aburumman R., Rosario A., Pradeep A., Cox T., Rehman S., Klutke J., Saleem A., Alomari A., Abusuliman A., Amreia M., Arwani R., Dababneh Y., Khan M., Jafri S. Outcomes of Simultaneous Liver and Kidney Transplant vs. Liver Transplant Alone: Insights from a Midwest Transplant Center AJT, Volume 25, Issue 8 Supplement 1 DISCLOSURES: M. Abusuliman: None.

Volume

25

Issue

8

First Page

S471

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