title: Comparing 10-yr renal outcomes in deceased donor and living donor liver transplants.
abstract: Few studies have explored whether the type of LT, deceased donor LT (DDLT) or living donor LT (LDLT), impacts long-term renal outcomes. We performed a retrospective analysis of 220 LT recipients at our institution to study their renal outcomes at 10 yr. Exclusion criteria were age ≤ 18 yr, graft survival ≤ 6 months, and multiorgan transplants; 108 DDLTs and 62 LDLTs were eligible. At baseline, DDLTs had a lower eGFR than LDLTs and 10.2% of DDLTs were on dialysis as compared to 0% of LDLTs. At 10 yr, seven DDLT and three LDLT recipients required dialysis or renal transplant (p = 0.75). In recipients with graft survival >6 months, DDLTs had a slower decline in eGFR as compared to LDLTs (p < 0.01). Among LDLTs, the decline in eGFR continued over the entire 10-yr period, whereas among DDLTs, the decline in eGFR slowed significantly after six months (p = 0.01). This difference between the two groups was not seen among patients in the highest quartile of baseline eGFR. Patient survival and graft survival were similar. In conclusion, the incidence of end-stage renal disease was similar in both DDLT and LDLT patients, but LDLT recipients seem to have a more sustained decline in eGFR when compared with DDLT recipients.
authors.affiliation: Division of Nephrology, University of Rochester Medical Center, Rochester, NY, USA.|Division of Nephrology and Multi-Organ Transplant Program, McGill University Health Centre, Montreal, QC, USA.
authors.forename: Shaifali
authors.initials: S
authors.lastname: Sandal
authors.affiliation: Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Anthony
authors.initials: A
authors.lastname: Almudevar
authors.affiliation: Division of Nephrology, University of Rochester Medical Center, Rochester, NY, USA.|Division of Nephrology, University of Wisconsin, Madison, WI, USA.
authors.forename: Sandesh
authors.initials: S
authors.lastname: Parajuli
authors.affiliation: Division of Nephrology, University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Anirban
authors.initials: A
authors.lastname: Bose
mesh_terms: D002102:Cadaver; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000453:epidemiology* / Q000209:etiology; D006085:Graft Survival; D006801:Humans; D015994:Incidence; D007677:Kidney Function Tests; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D014922:Wisconsin / Q000453:epidemiology
keywords: deceased donor; liver transplant; living donor; renal outcomes