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Kidney Week

Abstract: PO2142

Outcomes of Liver Transplant Recipients Who Developed AKI Before Liver Transplant

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Homkrailas, Piyavadee, University of California Los Angeles David Geffen School of Medicine, Los Angeles, United States
  • Bunnapradist, Suphamai, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States
Background

Multiple factors including level of kidney function, patient comorbidities and functional status may influence the decision whether to simultaneous liver-kidney (SLK) transplant or waiting for kidney function recovery in end stage liver disease. Consequence of waiting for subsequent kidney transplant (KT) those without kidney recovery is unknown.

Methods

The Organ Procurement and Transplantation Network/United Network for Organ Sharing (OPTN/UNOS) data of patients who were initially listed for liver transplant (LT) alone who also developed acute kidney injury (AKI) requiring dialysis within 60 days before LT and subsequently listed for KT during year 2000 – 2018 were included. Kidney function recovery defined as discontinuing dialysis >1 year. Our cohort therefore included 1) SLK, 2) listed for subsequent KT within one-year after LT and 3) listed for subsequent KT after recovery.

Results

A total of 7,853 liver recipients received dialysis within 60 days before LT. There were 110 patients receiving SLK and 445 patients listing for subsequent KT within one-year. Seven thousand two hundred and ninety-eight patients had kidney function recovery and 301 (3.8%) patients were listed for subsequent KT after dialysis free >1 year. One-year patient survival rates were 78.1% (95%CI 69.2 – 84.8) and 86.0% (82.4 – 88.9) among receiving SLK and listing for subsequent KT within one-year group, respectively. Ten-year patient survival rates were 45.5% (35.2 – 55.0) and 49.2% (42.8 – 55.3), respectively. Patients who survive and had dialysis-free more than one year had the best ten-year survival which were 62.9% (55.8 – 69.1).

Conclusion

Only 7.1% of liver recipients who developed AKI requiring dialysis within 60 days before LT did not have kidney recovery and remain on dialysis. These patients who received SLK had lower one-year patient survival but comparable ten-year patient survival compared to patients who listed for subsequent KT within one-year after LT.