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

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.

• Authors: L Sibulesky, R N Hansen, N Leca, C Blosser, A A Rahnemai-Azar, M I Montenovo, A A Dick, R Bakthavatsalam, S Rayhill, R Bhattacharya, J D Reyes
• Journal: Transplantation proceedings (Transplant Proc) Vol. 48 Issue 10 Pg. 3268-3273 (Dec 2016) ISSN: 1873-2623 [Electronic] United States
• PMID: 27931567 (Publication Type: Journal Article)
• Copyright: Published by Elsevier Inc.

Topics

• Attitude of Health Personnel
• Humans
• Kidney Failure, Chronic (complications, surgery)
• Kidney Transplantation (statistics & numerical data)
• Liver Cirrhosis (complications, surgery)
• Liver Transplantation
• Renal Dialysis
• Surgeons
• Surveys and Questionnaires
• United States