Outcomes of liver transplantation in patients with hepatorenal syndrome

Table 2 Comparing outcomes measures between liver transplantation alone vs simultaneous liver kidney transplantation including graft and patient survival as well as need for renal replacement therapy

Ref.	No. of LTA	No. of SLKT	Graft survival (LTA vs SLKT)	Patient survival (LTA vs SLKT)	Renal dysfunction post 1, 5 and 10 yr (LTA vs SLKT)	RRT post-transplantation (LTA vs SLKT)	Additional comments
Jeyarajah et al[81]	2442 (Cr > 2.0, nationawide)	29 (single center) + 414 (nationwide)	N/A	5 yr survival nationwide (50.4% vs 62.2%)	N/A	N/A	Interestingly, single center study had increased better survival in LTA than SLKT group
Campbell et al[80]	53	13	N/A	N/A	1 yr (1.4 mg/dL vs 1.5 mg/dL)	2% vs 0% (at 12 mo)	Adjusting for baseline characteristics, SLKT patients had lower Cr than LTA at 12 mo (P = 0.01)
Ruiz et al[83]	80 (all with HRS)	98 (22 with HRS and 76 with primary renal disease)	1 yr SLKT survival (liver: 76% and kidney: 76%)	1 yr survival (66% LTA vs 72% SLKT)	N/A	Post-op dialysis: (89% LTA pts for median of 9 d vs 55% SLKT pts for median 2.5 d)	1 yr acute kidney rejection in CLKT was 14% vs 23% in 5 yr LT cohort
Locke et al[84]	19137	1032	N/A	1 yr survival for pts with ≥ 3 mo RRT: (70.8% LTA vs 84.5% SLKT)	N/A	N/A	Even after matched-control analysis, there was no benefit in SLKT cohort vs LTA cohort outside of aforementioned RRT
Mehrabi et al[85] (literature review)	N/A	3536	Cumulative 5 yr SLKT survival of both organs (60.9%)	Cumulative 5 yr survival 42.6%	N/A	N/A	It is concluded that there is no definitive evidence of better graft/patient survival in SKLT vs LTA
Chava et al[114]	N/A	39	5 yr SLKT survival (liver: 73.7% and kidney: 70%)	73.7% SLKT patient survival at 5 yr	N/A	N/A	15 surviving patients (53.6%) had mild/moderate kidney dysfunction
Fong et al[82]	2774	1501	5 yr survival (58.9% LTA vs 65.3%, SLKT, P < 0.001)	5 yr survival (62.9% LTA vs 67.4% SLKT, P < 0.001)	0% with severe renal dysfunction	N/A	Liver graft survival and patient survival was better in SLKT vs LTA group
Martin et al[88] 2012	66026	2327	15% decreased risk of graft loss with SLKT vs LTA (P = 0.02)	N/A	N/A	N/A	SLKT had higher graft survival rates than both KALT and LAKT
Sharma et al[86]	2112 (received RRT within 90 d before LT)	N/A	N/A	78% LTA survival at 6 mo (not associated with RRT duration)	N/A	8.90%	Risk for non-recovery increased by 3.6%/day of pre-LT RRT
Catalano et al[89]	74	37	10 yr survival (77% LTA vs 80% SLKT, P = 0.85)	10 yr survival (79% LTA vs 86% SLKT, P = 0.56)	N/A	N/A	Acute rejection episodes involving the liver were less in SLKT vs LTA

LTA: Liver transplantation alone; SLKT: Simultaneous liver kidney transplantationl; RRT: Renal replacement therapy; HRS: Hepatorenal syndrome; KALT: Kidney after liver transplantation; LAKT: Liver after kidney transplantation; N/A: Not available.