title: Combined liver-kidney transplantation for polycystic liver and kidney disease: analysis from the United Network for Organ Sharing dataset.
abstract: The purpose of this study was to evaluate predictors of outcomes in combined liver-kidney transplants for polycystic liver and kidney disease.
  
  
  
  We queried the United Network for Organ Sharing dataset for combined liver-kidney transplants performed from 1988 to 2013.
  
  
  
  Out of 107 patients who had combined liver-kidney transplants for polycystic liver and kidney disease, 84 were women (78.5%) with a mean age of 54.9 ±7.2 years. Kaplan-Meier analysis demonstrated that patients undergoing liver-kidney transplantation for polycystic liver and kidney disease had better survival than patients with polycystic liver disease undergoing liver transplant alone and those undergoing liver-kidney transplantation for other indications. This group had a 1-, 3- and 5-year survival of 91%, 90% and 90%, respectively. Multivariable analysis demonstrated that an indication of polycystic liver and kidney disease for combined liver-kidney transplant (hazard ratio, 0.29; 95% confidence interval, 0.129-0.526; P < 0.001) and Model for End-Stage Liver Disease score (hazard ratio, 1.271; 95% confidence interval, 1.093-1.477; P = 0.002) are independently associated with patient survival. In a propensity score analysis adjusting for age, gender, cold ischaemia time and total bilirubin and excluding hepatitis C, we found that patients transplanted with combined liver-kidney for other indications have similar survival compared with our study group.
  
  
  
  Combined liver-kidney transplantation for polycystic liver and kidney disease can achieve good outcomes in selected patients. On Cox regression analysis, patients with polycystic liver and kidney disease undergoing liver-kidney transplantation had better survival compared with patients with combined liver-kidney for other indications. After excluding hepatitis C patients, those transplanted for polycystic liver and kidney disease vs other indications had similar survival after combined liver-kidney transplantation. Interestingly, patients in the combined polycystic liver and kidney disease group have significantly better outcomes than patients with polycystic liver disease undergoing liver transplant alone.
authors.affiliation: Transplant Center, University of Kentucky College of Medicine, Lexington, KY, USA.
authors.forename: Cristin
authors.initials: C
authors.lastname: Coquillard
authors.affiliation: Transplant Center, University of Kentucky College of Medicine, Lexington, KY, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Berger
authors.affiliation: Transplant Center, University of Kentucky College of Medicine, Lexington, KY, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Daily
authors.affiliation: Transplant Center, University of Kentucky College of Medicine, Lexington, KY, USA.
authors.forename: Malay
authors.initials: M
authors.lastname: Shah
authors.affiliation: Transplant Center, University of Kentucky College of Medicine, Lexington, KY, USA.
authors.forename: Xiaonan
authors.initials: X
authors.lastname: Mei
authors.affiliation: Transplant Center, University of Kentucky College of Medicine, Lexington, KY, USA.
authors.forename: Francesc
authors.initials: F
authors.lastname: Marti
authors.affiliation: Transplant Center, University of Kentucky College of Medicine, Lexington, KY, USA.
authors.forename: Roberto
authors.initials: R
authors.lastname: Gedaly
mesh_terms: D003560:Cysts / Q000150:complications / Q000601:surgery*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008107:Liver Diseases / Q000150:complications / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D007690:Polycystic Kidney Diseases / Q000150:complications / Q000601:surgery*; D011379:Prognosis; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology
keywords: combined liver/kidney transplant; polycystic liver and kidney disease; transplant outcomes