title: The liver neither protects the kidney from rejection nor improves kidney graft survival after combined liver and kidney transplantation from the same donor.
abstract: It has been proposed that the liver protects a simultaneously transplanted kidney from acute rejection. Using the United Network for Organ Sharing database, we compared the kidney allograft data from 248 combined liver and kidney transplants (LKT) with a control group comprising 206 contralateral kidney alone transplants (KAT) from the same donor. The LKT and KAT groups were identical with respect to most baseline parameters, save a greater degree of HLA matching in the KAT group. The overall 3-year graft survival rate was higher in the KAT group compared with the LKT group (80% vs 68%, P < 0.01). When these data were censored to remove death as a cause of graft loss and to minimize the matching effect, the 3-year survival rates were not statistically different (78% for KAT and 81% for LKT, P = NS). We conclude that the liver neither protects the kidney from rejection nor improves kidney allograft function or survival after LKT.
authors.affiliation: Division of Nephrology, University of California, Davis, USA.
authors.forename: S
authors.initials: S
authors.lastname: Katznelson
authors.forename: J M
authors.initials: JM
authors.lastname: Cecka
mesh_terms: D000328:Adult; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006648:Histocompatibility; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology*; D016031:Liver Transplantation / Q000276:immunology*; D008297:Male; D012042:Registries; D016019:Survival Analysis; D014019:Tissue Donors