The outcomes of simultaneous liver and kidney transplantation using donation after cardiac death organs

Tarek Alhamad, Christin Spatz, Tadahiro Uemura, Eric Lehman, Umar Farooq

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background. There has been a remarkable increase in simultaneous liver and kidney transplantations (SLK). As organ demand has increased, so has the use of donation after cardiac death (DCD). However, little is known about the outcomes of DCD in SLK.

Methods. We performed a retrospective analysis using the United Network for Organ Sharing database to compare the outcomes of DCD SLK to donation after brain death (DBD) and determine the impact of donor and recipient factors on allograft and patient survival.

Results. Between 2002 and 2011, a total of 3,026 subjects received SLK from DBD and 98 from DCD. Kidney, liver, and patient survival from DCD donors were inferior to DBD at 1, 3, and 5 years (P=0.0056, P=0.0035, and P=0.0205, respectively). With the use of the Cox model, DCD was a significant risk factor for kidney and liver allograft failure and patient mortality. Recipient factors that were associated with worse allograft and patient outcomes included black race, diabetes, being on a ventilator, hospitalization, delayed graft function, hepatocellular carcinoma, and intensive care unit stay. Older age of the donor was also associated with worse outcomes.

Conclusion. Despite the decreased allograft and patient survival compared with DBD, DCD SLK provides an acceptable option for SLK, with a survival probability of more than 50% at 5 years.

Original languageEnglish (US)
Pages (from-to)1190-1198
Number of pages9
JournalTransplantation
Volume98
Issue number11
DOIs
StatePublished - Dec 15 2014

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Liver Transplantation
Kidney Transplantation
Brain Death
Allografts
Survival
Tissue Donors
Delayed Graft Function
Kidney
Liver Failure
Mechanical Ventilators
Proportional Hazards Models
Intensive Care Units
Hepatocellular Carcinoma
Hospitalization
Databases
Mortality
Liver

All Science Journal Classification (ASJC) codes

  • Transplantation

Cite this

Alhamad, Tarek ; Spatz, Christin ; Uemura, Tadahiro ; Lehman, Eric ; Farooq, Umar. / The outcomes of simultaneous liver and kidney transplantation using donation after cardiac death organs. In: Transplantation. 2014 ; Vol. 98, No. 11. pp. 1190-1198.
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The outcomes of simultaneous liver and kidney transplantation using donation after cardiac death organs. / Alhamad, Tarek; Spatz, Christin; Uemura, Tadahiro; Lehman, Eric; Farooq, Umar.

In: Transplantation, Vol. 98, No. 11, 15.12.2014, p. 1190-1198.

Research output: Contribution to journalArticle

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