Renal Recovery After Liver Transplantation Alone in Patients With Liver Cirrhosis and Severe Chronic Kidney Disease With Normal Kidney Size
| Autor: | Ji Hoon Shin, Jai Won Chang, Shin Hwang, Dong-Hwan Jung, Tae-Yong Ha, Chul-Soo Ahn, Deok-Bog Moon, Gi-Won Song, Ki-Hun Kim, Kyoung Sik Cho, Soon Bae Kim, Sung-Gyu Lee |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Liver Cirrhosis Male medicine.medical_specialty Cirrhosis medicine.medical_treatment Renal function Kaplan-Meier Estimate Liver transplantation Kidney Gastroenterology chemistry.chemical_compound Internal medicine medicine Humans Renal replacement therapy Renal Insufficiency Chronic Retrospective Studies Transplantation Creatinine business.industry Organ Size Middle Aged medicine.disease Liver Transplantation stomatognathic diseases medicine.anatomical_structure chemistry Female lipids (amino acids peptides and proteins) Surgery business Glomerular Filtration Rate Kidney disease |
| Zdroj: | Transplantation Proceedings. 53:1719-1725 |
| ISSN: | 0041-1345 |
| DOI: | 10.1016/j.transproceed.2021.01.016 |
| Popis: | Background Most guidelines recommend simultaneous liver-kidney transplantation (SLKT) in patients with liver cirrhosis (LC) and severe chronic kidney disease (CKD) over liver transplantation alone (LTA). CKD, however, is not irreversible. This study evaluates the reversibility of kidney disease after LTA based on kidney size. Materials and methods In this single-center retrospective study, we classified 90 patients with LC and severe CKD into 3 groups: the normal kidney (NK)-LTA group (n=39), small kidney (SK)-LTA group (both kidneys Results The NK-LTA group had a lower percentage of hepatocellular carcinoma and a higher pre-liver transplantation (LT) estimated glomerular filtration rate. This group, however, was older, received livers from a higher percentage of deceased donors, and had a higher Child-Pugh score. Renal recovery, defined as the return of creatinine to their baseline, or a persistent change from baseline but not persistent (≥3 months) need for renal replacement therapy after LT, was found in 79% in the NK-LTA group, which was higher than 7.5% in the SK-LTA group. Renal and patient survival was found in 56% of the NK-LTA group, which was higher than 2.5% of the SK-LTA group. Conclusions There is a high percentage of renal recovery in the NK-LTA group, and accordingly, this does not justify SLKT, since this would result in a "waste" of kidneys. Therefore, KT after LT is recommended over SLKT for the LC patients with NK size. |
| Databáze: | OpenAIRE |
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