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Transplant Proc. 2016 Dec;48(10):3268-3273. doi: 10.1016/j.transproceed.2016.09.032.

Landscape of Kidney Transplantation in Patients With Compensated Liver Disease: Results of a Survey of Transplant Surgeons in the United States.

Author information

1
Department of Surgery, Division of Transplant Surgery, University of Washington, Seattle, Washington. Electronic address: lenasi@uw.edu.
2
Pharmaceutical Outcomes Research and Policy Program, School of Pharmacy, University of Washington, Seattle, Washington.
3
Department of Medicine, Division of Nephrology, University of Washington, Seattle, Washington.
4
Department of Surgery, Division of Transplant Surgery, University of Washington, Seattle, Washington.
5
Department of Medicine, Division of Gastroenterology, University of Washington, Seattle, Washington.

Abstract

BACKGROUND:

The therapeutic options that provide the best long-term outcome for patients who have a combination of end-stage renal disease and compensated cirrhosis are unknown.

METHODS:

Given the paucity of data and the lack of clinical guidance in this area, a national survey was conducted in the form of an e-mail-based questionnaire addressed to the transplantation surgeons registered with the American Society of Transplant Surgeons.

RESULTS:

Of the 818 surgeons invited to participate in the survey, 167 (20%) responded. Twenty-one (12.6%) respondents indicated that their program performed <50 kidney transplantations per year, 49 (29.3%) reported performing 50 to 100 kidney transplantations per year, and the majority, 97 (58.1%) of respondents, performed >100 kidney transplantations per year. The majority, 116 (69.5%), believed that compensated cirrhotic patients with end-stage renal disease could be considered for renal transplantation alone, 45 (26.9%) respondents believed that compensated cirrhotic patients on dialysis could only be considered for simultaneous liver-kidney transplantation, and 6 (3.6%) believed that this population of patients was not suitable for kidney transplantation alone.

CONCLUSIONS:

Our findings suggest that there is a substantial heterogeneity of opinion among transplantation surgeons towards transplantation options for compensated cirrhotic patients. Further data is needed to define best practices and clinical guidelines.

[Indexed for MEDLINE]

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