title: Landscape of Kidney Transplantation in Patients With Compensated Liver Disease: Results of a Survey of Transplant Surgeons in the United States.
abstract: BACKGROUND
  The therapeutic options that provide the best long-term outcome for patients who have a combination of end-stage renal disease and compensated cirrhosis are unknown.
  
  
  METHODS
  Given the paucity of data and the lack of clinical guidance in this area, a national survey was conducted in the form of an e-mail-based questionnaire addressed to the transplantation surgeons registered with the American Society of Transplant Surgeons.
  
  
  RESULTS
  Of the 818 surgeons invited to participate in the survey, 167 (20%) responded. Twenty-one (12.6%) respondents indicated that their program performed <50 kidney transplantations per year, 49 (29.3%) reported performing 50 to 100 kidney transplantations per year, and the majority, 97 (58.1%) of respondents, performed >100 kidney transplantations per year. The majority, 116 (69.5%), believed that compensated cirrhotic patients with end-stage renal disease could be considered for renal transplantation alone, 45 (26.9%) respondents believed that compensated cirrhotic patients on dialysis could only be considered for simultaneous liver-kidney transplantation, and 6 (3.6%) believed that this population of patients was not suitable for kidney transplantation alone.
  
  
  CONCLUSIONS
  Our findings suggest that there is a substantial heterogeneity of opinion among transplantation surgeons towards transplantation options for compensated cirrhotic patients. Further data is needed to define best practices and clinical guidelines.
authors.affiliation: Department of Surgery, Division of Transplant Surgery, University of Washington, Seattle, Washington. Electronic address: lenasi@uw.edu.
authors.forename: L
authors.initials: L
authors.lastname: Sibulesky
authors.affiliation: Pharmaceutical Outcomes Research and Policy Program, School of Pharmacy, University of Washington, Seattle, Washington.
authors.forename: R N
authors.initials: RN
authors.lastname: Hansen
authors.affiliation: Department of Medicine, Division of Nephrology, University of Washington, Seattle, Washington.
authors.forename: N
authors.initials: N
authors.lastname: Leca
authors.affiliation: Department of Medicine, Division of Nephrology, University of Washington, Seattle, Washington.
authors.forename: C
authors.initials: C
authors.lastname: Blosser
authors.affiliation: Department of Surgery, Division of Transplant Surgery, University of Washington, Seattle, Washington.
authors.forename: A A
authors.initials: AA
authors.lastname: Rahnemai-Azar
authors.affiliation: Department of Surgery, Division of Transplant Surgery, University of Washington, Seattle, Washington.
authors.forename: M I
authors.initials: MI
authors.lastname: Montenovo
authors.affiliation: Department of Surgery, Division of Transplant Surgery, University of Washington, Seattle, Washington.
authors.forename: A A
authors.initials: AA
authors.lastname: Dick
authors.affiliation: Department of Surgery, Division of Transplant Surgery, University of Washington, Seattle, Washington.
authors.forename: R
authors.initials: R
authors.lastname: Bakthavatsalam
authors.affiliation: Department of Surgery, Division of Transplant Surgery, University of Washington, Seattle, Washington.
authors.forename: S
authors.initials: S
authors.lastname: Rayhill
authors.affiliation: Department of Medicine, Division of Gastroenterology, University of Washington, Seattle, Washington.
authors.forename: R
authors.initials: R
authors.lastname: Bhattacharya
authors.affiliation: Department of Surgery, Division of Transplant Surgery, University of Washington, Seattle, Washington.
authors.forename: J D
authors.initials: JD
authors.lastname: Reyes
mesh_terms: D001291:Attitude of Health Personnel; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000601:surgery*; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D008103:Liver Cirrhosis / Q000150:complications / Q000601:surgery*; D016031:Liver Transplantation; D006435:Renal Dialysis; D066231:Surgeons; D011795:Surveys and Questionnaires; D014481:United States