Kidney Graft Outcomes in High Immunological Risk Simultaneous Liver‐Kidney Transplants
Recipients of simultaneous liver‐kidney transplantations (SLKTs) have a lower risk of rejection compared with recipients of kidney transplants alone. However, there is disagreement about the impact of pretransplant anti–human leukocyte antigen sensitization on patient and kidney graft survival in th...
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| Veröffentlicht in: | Liver transplantation 2020-04, Vol.26 (4), p.517-527 |
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| creator | Piñeiro, Gastón J. Rovira, Jordi Montagud‐Marrahí, Enrique Torregrosa, Jose V. Ríos, José Cucchiari, David Ugalde‐Altamirano, Jessica Ventura‐Aguiar, Pedro Gelpi, Rosana Palou, Eduard Colmenero, Jordi Navasa, Miquel Diekmann, Fritz Esforzado, Nuria |
| description | Recipients of simultaneous liver‐kidney transplantations (SLKTs) have a lower risk of rejection compared with recipients of kidney transplants alone. However, there is disagreement about the impact of pretransplant anti–human leukocyte antigen sensitization on patient and kidney graft survival in the long term. The aim of the study was to evaluate the impact of the recipient immunological risk and comorbidities in renal graft outcomes on SLKT. We reviewed the SLKTs performed in our center from May 1993 until September 2017. Patient and graft survival were analyzed according to the immunological risk, comorbidities, liver and kidney rejection episodes, immunosuppression, and infections. A total of 20 recipients of SLKT were considered in the high immunological risk (HIR) group, and 68 recipients were included in the low immunological risk (LIR) control group. The prevalence of hepatitis C virus infection, second renal transplant, and time on dialysis prior to transplantation were significantly higher in the HIR group. The incidence of acute kidney rejection was higher in the HIR group (P |
| doi_str_mv | 10.1002/lt.25726 |
| format | Article |
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However, there is disagreement about the impact of pretransplant anti–human leukocyte antigen sensitization on patient and kidney graft survival in the long term. The aim of the study was to evaluate the impact of the recipient immunological risk and comorbidities in renal graft outcomes on SLKT. We reviewed the SLKTs performed in our center from May 1993 until September 2017. Patient and graft survival were analyzed according to the immunological risk, comorbidities, liver and kidney rejection episodes, immunosuppression, and infections. A total of 20 recipients of SLKT were considered in the high immunological risk (HIR) group, and 68 recipients were included in the low immunological risk (LIR) control group. The prevalence of hepatitis C virus infection, second renal transplant, and time on dialysis prior to transplantation were significantly higher in the HIR group. The incidence of acute kidney rejection was higher in the HIR group (P<0.01). However, death‐censored kidney graft survival as well as the estimated glomerular filtration rate at follow‐up were not different between the 2 groups. Comorbidities, but not the immunological risk, impact negatively on patient survival. Despite the higher incidence of rejection in the HIR SLKT group, longterm renal function and graft survival were similar to the LIR group.</description><identifier>ISSN: 1527-6465</identifier><identifier>EISSN: 1527-6473</identifier><identifier>DOI: 10.1002/lt.25726</identifier><identifier>PMID: 32011089</identifier><language>eng</language><publisher>United States: Wolters Kluwer Health, Inc</publisher><subject>Dialysis ; Glomerular filtration rate ; Graft rejection ; Graft Rejection - epidemiology ; Graft Survival ; Hepatitis C ; Histocompatibility antigen HLA ; Humans ; Immunology ; Immunosuppression ; Kidney transplantation ; Kidney Transplantation - adverse effects ; Kidney transplants ; Liver transplantation ; Liver Transplantation - adverse effects ; Renal Dialysis ; Renal function ; Retrospective Studies ; Transplants & implants ; Treatment Outcome</subject><ispartof>Liver transplantation, 2020-04, Vol.26 (4), p.517-527</ispartof><rights>Copyright © 2020 by the American Association for the Study of Liver Diseases.</rights><rights>2020 by the American Association for the Study of Liver Diseases.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3496-abdc8f78c5a72ffbc9a4cb4bfea374146200e042e6c8bdcbc6088365bd68bc463</citedby><cites>FETCH-LOGICAL-c3496-abdc8f78c5a72ffbc9a4cb4bfea374146200e042e6c8bdcbc6088365bd68bc463</cites><orcidid>0000-0001-8737-5005</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Flt.25726$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Flt.25726$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32011089$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Piñeiro, Gastón J.</creatorcontrib><creatorcontrib>Rovira, Jordi</creatorcontrib><creatorcontrib>Montagud‐Marrahí, Enrique</creatorcontrib><creatorcontrib>Torregrosa, Jose V.</creatorcontrib><creatorcontrib>Ríos, José</creatorcontrib><creatorcontrib>Cucchiari, David</creatorcontrib><creatorcontrib>Ugalde‐Altamirano, Jessica</creatorcontrib><creatorcontrib>Ventura‐Aguiar, Pedro</creatorcontrib><creatorcontrib>Gelpi, Rosana</creatorcontrib><creatorcontrib>Palou, Eduard</creatorcontrib><creatorcontrib>Colmenero, Jordi</creatorcontrib><creatorcontrib>Navasa, Miquel</creatorcontrib><creatorcontrib>Diekmann, Fritz</creatorcontrib><creatorcontrib>Esforzado, Nuria</creatorcontrib><title>Kidney Graft Outcomes in High Immunological Risk Simultaneous Liver‐Kidney Transplants</title><title>Liver transplantation</title><addtitle>Liver Transpl</addtitle><description>Recipients of simultaneous liver‐kidney transplantations (SLKTs) have a lower risk of rejection compared with recipients of kidney transplants alone. However, there is disagreement about the impact of pretransplant anti–human leukocyte antigen sensitization on patient and kidney graft survival in the long term. The aim of the study was to evaluate the impact of the recipient immunological risk and comorbidities in renal graft outcomes on SLKT. We reviewed the SLKTs performed in our center from May 1993 until September 2017. Patient and graft survival were analyzed according to the immunological risk, comorbidities, liver and kidney rejection episodes, immunosuppression, and infections. A total of 20 recipients of SLKT were considered in the high immunological risk (HIR) group, and 68 recipients were included in the low immunological risk (LIR) control group. The prevalence of hepatitis C virus infection, second renal transplant, and time on dialysis prior to transplantation were significantly higher in the HIR group. The incidence of acute kidney rejection was higher in the HIR group (P<0.01). However, death‐censored kidney graft survival as well as the estimated glomerular filtration rate at follow‐up were not different between the 2 groups. Comorbidities, but not the immunological risk, impact negatively on patient survival. Despite the higher incidence of rejection in the HIR SLKT group, longterm renal function and graft survival were similar to the LIR group.</description><subject>Dialysis</subject><subject>Glomerular filtration rate</subject><subject>Graft rejection</subject><subject>Graft Rejection - epidemiology</subject><subject>Graft Survival</subject><subject>Hepatitis C</subject><subject>Histocompatibility antigen HLA</subject><subject>Humans</subject><subject>Immunology</subject><subject>Immunosuppression</subject><subject>Kidney transplantation</subject><subject>Kidney Transplantation - adverse effects</subject><subject>Kidney transplants</subject><subject>Liver transplantation</subject><subject>Liver Transplantation - adverse effects</subject><subject>Renal Dialysis</subject><subject>Renal function</subject><subject>Retrospective Studies</subject><subject>Transplants & implants</subject><subject>Treatment Outcome</subject><issn>1527-6465</issn><issn>1527-6473</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kM1Kw0AUhQdRbK2CTyABN25S5y-TyVKKtsWAoBXchcl0UqdOkjqTKN35CD6jT-JoagXB1T2Lj-8eDgDHCA4RhPjcNEMcxZjtgD6KcBwyGpPdbWZRDxw4t4QQoSiB-6BHsI-QJ33wcK3nlVoHYyuKJrhpG1mXygW6CiZ68RhMy7KtalMvtBQmuNXuKbjTZWsaUam6dUGqX5T9eHvfWGZWVG5lRNW4Q7BXCOPU0eYOwP3V5Ww0CdOb8XR0kYaS0ISFIp9LXsRcRiLGRZHLRFCZ07xQgsQUUYYhVJBixST3aC4Z5JywKJ8znkvKyACcdd6VrZ9b5Zqs1E4qY7qGGSYRJCShFHv09A-6rFtb-XaeijlKuH_2K5S2ds6qIltZXQq7zhDMvtbOTJN9r-3Rk42wzUs134I_83og7IBXbdT6X1GWzjrhJ5dGiVE</recordid><startdate>202004</startdate><enddate>202004</enddate><creator>Piñeiro, Gastón J.</creator><creator>Rovira, Jordi</creator><creator>Montagud‐Marrahí, Enrique</creator><creator>Torregrosa, Jose V.</creator><creator>Ríos, José</creator><creator>Cucchiari, David</creator><creator>Ugalde‐Altamirano, Jessica</creator><creator>Ventura‐Aguiar, Pedro</creator><creator>Gelpi, Rosana</creator><creator>Palou, Eduard</creator><creator>Colmenero, Jordi</creator><creator>Navasa, Miquel</creator><creator>Diekmann, Fritz</creator><creator>Esforzado, Nuria</creator><general>Wolters Kluwer Health, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8737-5005</orcidid></search><sort><creationdate>202004</creationdate><title>Kidney Graft Outcomes in High Immunological Risk Simultaneous Liver‐Kidney Transplants</title><author>Piñeiro, Gastón J. ; 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However, there is disagreement about the impact of pretransplant anti–human leukocyte antigen sensitization on patient and kidney graft survival in the long term. The aim of the study was to evaluate the impact of the recipient immunological risk and comorbidities in renal graft outcomes on SLKT. We reviewed the SLKTs performed in our center from May 1993 until September 2017. Patient and graft survival were analyzed according to the immunological risk, comorbidities, liver and kidney rejection episodes, immunosuppression, and infections. A total of 20 recipients of SLKT were considered in the high immunological risk (HIR) group, and 68 recipients were included in the low immunological risk (LIR) control group. The prevalence of hepatitis C virus infection, second renal transplant, and time on dialysis prior to transplantation were significantly higher in the HIR group. The incidence of acute kidney rejection was higher in the HIR group (P<0.01). However, death‐censored kidney graft survival as well as the estimated glomerular filtration rate at follow‐up were not different between the 2 groups. Comorbidities, but not the immunological risk, impact negatively on patient survival. Despite the higher incidence of rejection in the HIR SLKT group, longterm renal function and graft survival were similar to the LIR group.</abstract><cop>United States</cop><pub>Wolters Kluwer Health, Inc</pub><pmid>32011089</pmid><doi>10.1002/lt.25726</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0001-8737-5005</orcidid></addata></record> |
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| ispartof | Liver transplantation, 2020-04, Vol.26 (4), p.517-527 |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; Alma/SFX Local Collection |
| subjects | Dialysis Glomerular filtration rate Graft rejection Graft Rejection - epidemiology Graft Survival Hepatitis C Histocompatibility antigen HLA Humans Immunology Immunosuppression Kidney transplantation Kidney Transplantation - adverse effects Kidney transplants Liver transplantation Liver Transplantation - adverse effects Renal Dialysis Renal function Retrospective Studies Transplants & implants Treatment Outcome |
| title | Kidney Graft Outcomes in High Immunological Risk Simultaneous Liver‐Kidney Transplants |
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