Kidney Week

Abstract: SA-PO684

Combined Liver-Kidney Transplant in Children

Session Information

• Pediatric Nephrology - 2
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

• 1900 Pediatric Nephrology

Authors

• Kazi, Amber Jasmine, Seattle Children's Hospital, Seattle, Washington, United States

Amber Jasmine Kazi, MD

• Kumar, Juhi, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, United States

Juhi Kumar, MD, MPH

• Smith, Jodi M., Seattle Children's Hospital, Seattle, Washington, United States

Jodi M. Smith, MD, MPH

• Hayde, Nicole A., Montefiore Medical Center, New York, New York, United States

Nicole A. Hayde, MD, MS

• Harshman, Lyndsay, University of Iowa Health Care, Iowa City, Iowa, United States

Lyndsay Harshman, MD, MS

• Douglas, Chloe E., Seattle Children's Hospital, Seattle, Washington, United States

Chloe E. Douglas, MD

• Kizilbash, Sarah J., University of Minnesota Twin Cities, Minneapolis, Minnesota, United States

Sarah J. Kizilbash, MD, MS

• Bartosh, Sharon M., University of Wisconsin-Madison, Madison, Wisconsin, United States

Sharon M. Bartosh, MD

• Engen, Rachel M., University of Wisconsin-Madison, Madison, Wisconsin, United States

Rachel M. Engen, MD, MS

Background

Data describing outcomes of pediatric combined liver-kidney transplant (CLKT) are limited.

Methods

Retrospective cohort study of pediatric CLKT, liver-alone transplants (LT), and kidney-alone transplants (KT) in US from 1/1/2001 to 12/31/2019 using SRTR data. Primary outcomes include demographic and clinical characteristics, graft, and patient survival.

Results

There were 284 CLKT recipients with a median age of 10 yrs; 22.5% had polycystic kidney disease and 18.7% had primary hyperoxaluria (Table 1). CLKT recipients were more likely to have a history of prior transplant, be listed at multiple centers, and be on dialysis prior to CLKT. CLKT were more likely to receive a whole liver and be listed with exception points compared to LT. CLKT were more likely to have en bloc kidney transplants, KDPI 35-85% donor kidneys, and DGF compared to KT. CLKT graft survival was superior to LT but inferior to KT long term (Fig 1). CLKT patient survival was inferior to KT but similar to LT.

Conclusion

CLKT recipients have different transplant characteristics and outcomes compared to LT or KT alone recipients. Further research is needed to understand the factors driving these differences.

Table 1. Pt Characteristics

Figure 1. Graft Survival