Abstract: FR-PO1018
Outcomes of Simultaneous Liver-Kidney vs. Liver Transplant Alone in End-Stage Liver Disease with CKD: A National Inpatient Sample Analysis
Session Information
- Transplantation: Clinical - Pharmacology and Nonkidney Solid Organ Transplants
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Ghimire, Manoj, St Barnabas Hospital, New York, New York, United States
- Poudel, Sajana, John H Stroger Jr Hospital of Cook County, Chicago, Illinois, United States
- Ghimire, Kalpana, St Barnabas Hospital, New York, New York, United States
- Shrestha, Karun, St Barnabas Hospital, New York, New York, United States
- Subedi, Prakriti, St Barnabas Hospital, New York, New York, United States
- Sangam, Sangam, St Barnabas Hospital, New York, New York, United States
- Dandamudi, Mrunalini, St Barnabas Hospital, New York, New York, United States
- Bhatta, Gaurab, St George's university, Grenada, Grenada
- Madera, Irvianny, St Barnabas Hospital, New York, New York, United States
- Flores Chang, Bessy Suyin, St Barnabas Hospital, New York, New York, United States
Background
Renal failure following orthotopic liver transplantation (OLT) is a significant risk factor for poor overall survival. Pre-OLT renal dysfunction is predictive of post-OLT renal failure. Consequently, simultaneous liver-kidney transplantation (SLKT) has been used to treat patients with end-stage liver disease and renal dysfunction; however, data comparing overall outcomes between SLKT and OLT alone remain limited.
Methods
We conducted a retrospective analysis of adults (≥18 years) from the 2016–2021 National Inpatient Sample (NIS) database with chronic kidney disease (CKD) with eGFR ≤45 mL/min/1.73 m2, who underwent OLT, excluding those on dialysis. Patients were identified using ICD-10 codes and categorized into OLT alone or SLKT groups. Demographics, hospital outcomes, and post-transplant complications were compared between these groups.
Results
A total of 4,310 patients underwent OLT during the study period, out of which 2,330 underwent SLKT and 1,980 underwent OLT alone. The mean age of the study population was 57.0 ± 6.5 years, and 43% were female. Hepatorenal syndrome was present in 56% of the cohort (58% in SLKT vs. 53% in OLT). Post-transplant acute kidney injury (AKI) occurred significantly less frequently in the SLKT group compared to OLT alone (68% vs. 90%, p < 0.001). SLKT patients also experienced shorter hospital stays (mean, 37 vs. 45 days, p = 0.004). There was no significant difference in in-hospital mortality (6.65% vs. 8.59%, p = 0.31) or total hospital charges (mean, $1,159,427 vs $1,244,109) between the groups.
Conclusion
SLKT is associated with reduced post-transplant acute kidney injury and shorter hospital stays compared to OLT alone, with similar in-hospital mortality. Prospective studies are needed to further evaluate post-transplant outcomes.