Simultaneous liver-kidney transplantation: a survey of US transplant centers.
Am J Transplant
; 12(11): 3119-27, 2012 Nov.
Article
in En
| MEDLINE
| ID: mdl-22759208
ABSTRACT
Consensus recommendations have been published to help better define those patients who would benefit from simultaneous liver-kidney transplantation (SLK). We conducted a survey of transplant centers that perform SLK (n = 88, 65% response rate) to determine practice patterns in the United States. The majority of centers (73%) stated that they use dialysis duration whereas only 30% of centers use acute kidney injury duration as a criterion for determining need for SLK. Dialysis duration >4 weeks was used by 32% of centers, >6 weeks by 37% and >8 weeks by 32% of centers. Glomerular filtration rate (GFR) was estimated using the modified diet in renal disease (MDRD)-4 equation in roughly half of centers whereas the MDRD-6 equation was used by only 6%. In patients with chronic kidney disease, GFR < 40 mL/min was used by 24% of centers as a criterion for SLK transplants instead of the recommended threshold of < 30 mL/min. Regional differences in practices were also observed. This survey demonstrates significant variation in the criteria used for SLK among transplant centers, with few centers following the current published recommendations, and emphasizes the need for evidence-based guidelines and uniformity in studying renal dysfunction in liver transplant candidates.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Kidney Transplantation
/
Liver Transplantation
/
Liver Failure
/
Kidney Failure, Chronic
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Guideline
/
Incidence_studies
/
Prognostic_studies
/
Qualitative_research
/
Risk_factors_studies
Limits:
Female
/
Humans
/
Male
Country/Region as subject:
America do norte
Language:
En
Journal:
Am J Transplant
Journal subject:
TRANSPLANTE
Year:
2012
Document type:
Article
Affiliation country:
Estados Unidos