Simultaneous Liver-Kidney Transplantation: What are Our Obligations to the Kidney Only Recipient?

AbstractPurpose of ReviewThere has been a recent explosion in the number of simultaneous liver and kidney (SLK) transplants performed. This practice is crowding out the population of ESRD patients waiting for a kidney transplant.Recent FindingsIt has been alleged from retrospective, anecdotal reports, often from voluntary registries, that there is a survival advantage for those with renal dysfunction that receive an SLK compared to Liver Transplant Alone. However, this survival advantage is quite small —about 5% at 1 and 5 years at best. A new algorithm introduced in 2016 by UNOS may make this problem worse by allowing SLK transplant for patients who may not have permanent kidney failure with a glomerular filtration rate (GFR) as high as 30cm3/min.SummaryThe transplant community needs to have a high degree of vigilance to identify which groups of patients are being disadvantaged when reallocation schemes are created to direct organs from one group to another.
Source: Current Transplantation Reports - Category: Transplant Surgery Source Type: research