title: Outcome of combined liver and kidney transplantation in hepatitis C: a single-center long-term follow-up experience.
abstract: BACKGROUND
  Hepatitis C (HCV) cirrhosis is the prevalent liver disease requiring liver transplantation in the United States. Candidates who also have end-stage renal disease, chronic renal disease stage 4, or prolonged hepatorenal syndrome are considered for combined liver and kidney transplantation (CLKT).
  
  
  METHODS
  We performed a retrospective study of HCV(+) and HCV(-) CLKT patients with more than 12 months of follow-up and HCV(+) patients with isolated liver transplant (OLT) to compare the outcomes of various groups.
  
  
  RESULTS
  Since 1988, 2983 OLTs were performed at our institution including 58 CLKTs. Of these, 23 were HCV(+) subjects who were significantly older than HCV(-) CLKT patients. Race, pretransplant dialysis time, renal indication for CLKT, Model for End-stage Liver Disease score, donor age, liver and kidney rejection as well as occurrence of posttransplant hypertension were similar among HCV(+) and HCV(-) CLKT patients. Posttransplant diabetes was observed in 80% of the HCV(+) group and 30% of the HCV(-) group (P = .01). Renal function seemed to be better in HCV(-) when compared with HCV(+) subjects at 5 years (P = .09). Overall patient survival for HCV(+) CLKT, HCV(-) CLKT, and HCV(+) OLT groups at 1, 2, and 5 years were not significantly different (P = .6).
  
  
  CONCLUSIONS
  HCV positivity should not exclude appropriate candidates for CLKT.
authors: Recanti/Miller Transplant Institute, Mount Sinai Medical Center, New York, USA.
authors: A C
authors: AC
authors: del Pozo
authors: J D R
authors: JD
authors: Martín
authors: G
authors: G
authors: Rodriguez-Laiz
authors: M
authors: M
authors: Sturdevant
authors: K
authors: K
authors: Iyer
authors: M
authors: M
authors: Schwartz
authors: T
authors: T
authors: Schiano
authors: S
authors: S
authors: Lerner
authors: S
authors: S
authors: Ames
authors: J
authors: J
authors: Bromberg
authors: S
authors: S
authors: Thung
authors: G
authors: G
authors: de Boccardo
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D005260:Female; D005500:Follow-Up Studies; D006526:Hepatitis C / Q000601:surgery*; D006801:Humans; D016030:Kidney Transplantation / Q000401:mortality / Q000473:pathology / Q000502:physiology*; D016031:Liver Transplantation / Q000401:mortality / Q000473:pathology / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D017741:Survivors; D013997:Time Factors; D016896:Treatment Outcome