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Kidney utilization and outcomes of liver transplant recipients who were listed for kidney after liver transplant after the implementation of safety net policy.
Homkrailas, Piyavadee; Ayoub, Walid S; Martin, Paul; Bunnapradist, Suphamai.
Afiliación
  • Homkrailas P; Department of Medicine, Division of Nephrology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
  • Ayoub WS; Department of Medicine, Division of Nephrology, Bhumibol Adulyadej Hospital, Bangkok, Thailand.
  • Martin P; Department of Medicine, Karsh Division of Gastroenterology and Hepatology, Comprehensive Transplant Center, Cedars Sinai Medical Center, Los Angeles, California, USA.
  • Bunnapradist S; Division of Digestive Health and Liver Diseases, Miller School of Medicine, University of Miami, Miami, Florida, USA.
Clin Transplant ; 36(2): e14522, 2022 02.
Article en En | MEDLINE | ID: mdl-34716954
In 2017, United Network for Organ Sharing (UNOS) established the safety net policy with set criteria for offering kidney transplantation (KT) for patients who developed end-stage renal disease between 60 and 365 days after liver transplant (LT). We provide an update on the impact of the policy. We analyzed UNOS data of liver recipients transplanted between 1987 and 2020 who developed acute kidney injury requiring dialysis within 60 days before or after LT and subsequently listed for KT. We identified 407 patients who were listed for kidney after LT before policy and 248 patients after policy. Median waiting time to KT was shorter after policy (324 days vs. 2827 days). There was a higher proportion of candidates who were listed for subsequent KT within 1-year after policy (94.8% vs. 63.6%). KT rate was also higher after policy (87.7 vs. 30.7 per 100 patient-years at risk). Most importantly, we started to observe a net negative kidney utilization in end-stage liver disease setting (i.e., summation of simultaneous liver kidney and kidney after liver transplant in the first-year after LT has decreased from 1086 to 876 transplants in 2019). Such findings are consistent with a more efficient system and more appropriate allocation of organs.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Trasplante de Riñón / Trasplante de Hígado / Enfermedad Hepática en Estado Terminal Tipo de estudio: Prognostic_studies Límite: Female / Humans / Male Idioma: En Revista: Clin Transplant Asunto de la revista: TRANSPLANTE Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Trasplante de Riñón / Trasplante de Hígado / Enfermedad Hepática en Estado Terminal Tipo de estudio: Prognostic_studies Límite: Female / Humans / Male Idioma: En Revista: Clin Transplant Asunto de la revista: TRANSPLANTE Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos