title: Kidney transplantation after previous liver transplantation: analysis of the organ procurement transplant network database.
abstract: BACKGROUND
  Patients after liver transplant have a high incidence of chronic kidney disease and end-stage renal disease (ESRD). We investigated kidney transplantation after liver transplantation using the Organ Procurement Transplant Network database.
  
  
  METHODS
  The Organ Procurement Transplant Network database was queried for patients who received kidney transplantation after previous liver transplantation. These patients were compared with patients who received primary kidney transplantation alone during the same time period.
  
  
  RESULTS
  Between 1997 and 2008, 157,086 primary kidney transplants were performed. Of these, 680 deceased donor kidney transplants and 410 living donor kidney transplants were performed in previous recipients of liver transplants. The number of kidney after liver transplants performed each year has increased from 37 per year to 124 per year in 2008. The time from liver transplant to kidney transplant increased from 8.2 to 9.0 years for living donor transplants and from 5.4 to 9.6 years for deceased donor. The 1, 3, and 5 year actuarial graft survival in both living donor kidney after liver transplant and deceased donor kidney after liver transplant are less than the kidney transplant alone patients. However, the death-censored graft survivals are equal. The patient survival is also less but is similar to what would be expected in liver transplant recipients who did not have ESRD. In 2008, kidney after liver transplantation represented 0.9% of the total kidney alone transplants performed in the United States.
  
  
  CONCLUSIONS
  Kidney transplantation is an appropriate therapy for selected patients who develop ESRD after liver transplantation.
authors.affiliation: Department of Transplantation, Mayo Clinic, Jacksonville, FL 32224, USA. Gonwa.thomas@mayo.edu
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Gonwa
authors.forename: Maureen A
authors.initials: MA
authors.lastname: McBride
authors.forename: Martin L
authors.initials: ML
authors.lastname: Mai
authors.forename: Hani M
authors.initials: HM
authors.lastname: Wadei
mesh_terms: D065095:Calcineurin Inhibitors; D016208:Databases, Factual; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000209:etiology; D016030:Kidney Transplantation / Q000401:mortality / Q000706:statistics & numerical data*; D016031:Liver Transplantation / Q000009:adverse effects / Q000706:statistics & numerical data*; D019520:Living Donors / Q000706:statistics & numerical data; D013997:Time Factors; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000458:organization & administration / Q000706:statistics & numerical data*; D014481:United States
chemical_list: D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents