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Combined Transplantations

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Contemporary Liver Transplantation

Abstract

The numbers of simultaneous liver and kidney (SLK) transplantation have increased since introduction of Model for End-Stage Liver Disease (MELD) score for allocation of orthotropic liver transplant (OLT) in February 2002. For OLT candidates with concurrent end-stage kidney failure, SLK transplantation is a well-established indication for suitable candidates. However, there is lack of evidence-based guidelines to determine at what threshold a kidney transplant should be offered simultaneously to those who have chronic kidney disease (CKD) or prolonged acute kidney injury (AKI) while awaiting a liver transplant. Accurate assessment of the degree of existing renal dysfunction can be difficult and estimating progression of established CKD and likelihood of renal function recovery in those with AKI can be challenging. Etiology of renal dysfunction in liver failure patients, burden of CKD after liver transplantation, and usual indications for SLK transplantation are presented in this review. Finally, the UNOS (United Network for Organ Sharing) initiatives to formalize the SLK listing indications are also discussed.

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Authors and Affiliations

  1. Jefferson University Hospitals, Philadelphia, PA, USA

    Pooja Singh

  2. Division of Nephrology, Department of Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, USA

    Jerry McCauley

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  1. Pooja Singh
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  2. Jerry McCauley
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Correspondence to Pooja Singh .

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Editors and Affiliations

  1. Jefferson Liver Tumor Center Division of Transplantation, Thomas Jefferson University Hospital Kimmel Cancer Center, Philadelphia, Pennsylvania, USA

    Cataldo Doria

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Singh, P., McCauley, J. (2016). Combined Transplantations. In: Doria, C. (eds) Contemporary Liver Transplantation. Springer, Cham. https://doi.org/10.1007/978-3-319-05543-5_8-2

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  • DOI: https://doi.org/10.1007/978-3-319-05543-5_8-2

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  • Online ISBN: 978-3-319-05543-5

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Chapter history

  1. Latest

    Combined Transplantations
    Published:
    24 September 2016

    DOI: https://doi.org/10.1007/978-3-319-05543-5_8-2

  2. Original

    Combined Transplantations
    Published:
    11 February 2016

    DOI: https://doi.org/10.1007/978-3-319-05543-5_8-1

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