Simultaneous Liver-Kidney Transplant: Too Many or Just Enough?

摘要: For liver transplant candidates with advanced kidney dysfunction, simultaneous liver-kidney (SLK) transplantation is an important option. As the incidence of severe dysfunction has increased over past decade, so have numbers SLK transplants. This engendered controversy within community because transplants draw deceased donor kidneys from candidate pool. Because recovery after alone (LTA) difficult to predict, indications for are not precisely defined. Candidates hepatorenal syndrome can as much 12 weeks on dialysis, whereas those CKD may early ESRD LTA perioperative events and calcineurin inhibitor exposure. Although large observational studies generally show slightly improved survival in recipients compared LTA, inferences these limited by selection biases. Therefore, a true benefit without still unproved. practices vary, more acute injury, less disease or ESRD. The debate appropriate primarily one optimal utilization vs best interests individual candidates.