18 February 2022 : Original article
Impact on Waitlist Outcomes from Changes in the Medical Eligibility of Candidates for Simultaneous Liver-Kidney Transplantation Following Implementation of the 2017 Organ Procurement and Transplantation Network/United Network for Organ Sharing Policy in the United States
Shingo Shimada1ADEF*, Toshihiro Kitajima1BCE, Yukiko Suzuki1BD, Yasutaka Kuno1BD, Tayseer Shamaa1BC, Tommy Ivanics
1BCE, Kelly Collins1DE, Michael Rizzari1BD, Atsushi Yoshida1BD, Marwan Abouljoud1BD, Dilip Moonka2BD, Shunji Nagai1ACE
DOI: 10.12659/AOT.934850
Ann Transplant 2022; 27:e934850
Table 6 Risk factors of 1-year graft loss and mortality after simultaneous liver-kidney transplantation.
| Factors | Graft loss | Mortality | ||||
|---|---|---|---|---|---|---|
| aHR* | 95% CI | P value | aHR* | 95% CI | P value | |
| Donor age 40–59y (ref. <40y) | 1.69 | 1.20–2.38 | 0.002 | 1.74 | 1.21–2.50 | 0.002 |
| Donor age ≥60y (ref. <40y) | 3.32 | 1.72–6.44 | <0.001 | 3.44 | 1.76–6.71 | <0.001 |
| Mechanically ventilated | 1.78 | 1.13–2.79 | 0.01 | 1.75 | 1.09–2.81 | 0.02 |
| Serum sodium <135 mEq/L (ref. 135≤, <145) | 1.44 | 1.03–2.02 | 0.03 | 1.57 | 1.10–2.22 | 0.01 |
| Serum sodium ≥145 mEq/L (ref. 135≤, <145) | 2.70 | 1.19–6.11 | 0.01 | 2.28 | 0.88–5.91 | 0.08 |
| After the 2017 policy (ref. Before the 2017 policy) | 1.57 | 1.11–2.22 | 0.01 | 1.64 | 1.14–2.35 | 0.007 |
| * Hazards were adjusted by a multivariable Cox regression model for the following variables present at the time of SLK: recipient age, recipient race, encephalopathy, ascites, mechanical ventilation, dialysis, recipient diabetes, recipient body mass index (BMI), model for end-stage liver disease (MELD) score, Karnofsky score, serum sodium, cold ischemia time, donor age, donor BMI, donor race, donation after circulatory death donor, registered era, and United Network for Organ Sharing (UNOS) regions. aHR – adjusted hazard ratio; CI – confidence interval; SLK – simultaneous liver-kidney transplantation. | ||||||