BACKGROUND: The protective effect of the liver allograft when simultaneously transplanted with a kidney in the setting of allosensitization is unclear. METHODS: We analyzed the significance of sensitization, defined based on positive cytotoxicity crossmatches, positive flow cytometry crossmatches, and/or the presence of high levels of donor-specific antibodies, on the outcomes of simultaneous liver and kidney (SLK) transplantation. We reviewed 56 SLK performed at our center through December 31, 2011 and identified 13 patients who met high sensitization criteria. RESULTS: Median patient survival was not significantly different: 86 months (95% confidence interval [CI], 47-135) for nonsensitized patients versus 151 months (95% CI, 4 to ∞) for sensitized patients (P=0.5). The 5-year survival was 67% (95% CI, 0.5-0.8) in the nonsensitized group and 64% (95% CI, 0.3-0.9) in the sensitized group. There were six renal allograft failures in the nonsensitized group but none in the sensitized group. The adjusted hazard ratios associated with the risk of death or the combined risk of death or renal allograft failure were 0.7 (95% CI, 0.1-3.8) and 0.4 (95% CI, 0.1-2.2) for sensitized versus nonsensitized patients. There were significantly more renal allograft rejections in the sensitized group (5 vs. 1; P=0.002) in the first year after transplantation, only one showing C4d positivity. Creatinine levels at 1 year after transplantation were similar: 1.5 mg/dL in the nonsensitized group versus 1.36 mg/dL in the sensitized group (P=0.6). CONCLUSION: Sensitization does not appear to have a significant negative impact on the survival of SLK patients.
BACKGROUND: The protective effect of the liver allograft when simultaneously transplanted with a kidney in the setting of allosensitization is unclear. METHODS: We analyzed the significance of sensitization, defined based on positive cytotoxicity crossmatches, positive flow cytometry crossmatches, and/or the presence of high levels of donor-specific antibodies, on the outcomes of simultaneous liver and kidney (SLK) transplantation. We reviewed 56 SLK performed at our center through December 31, 2011 and identified 13 patients who met high sensitization criteria. RESULTS: Median patient survival was not significantly different: 86 months (95% confidence interval [CI], 47-135) for nonsensitized patients versus 151 months (95% CI, 4 to ∞) for sensitized patients (P=0.5). The 5-year survival was 67% (95% CI, 0.5-0.8) in the nonsensitized group and 64% (95% CI, 0.3-0.9) in the sensitized group. There were six renal allograft failures in the nonsensitized group but none in the sensitized group. The adjusted hazard ratios associated with the risk of death or the combined risk of death or renal allograft failure were 0.7 (95% CI, 0.1-3.8) and 0.4 (95% CI, 0.1-2.2) for sensitized versus nonsensitized patients. There were significantly more renal allograft rejections in the sensitized group (5 vs. 1; P=0.002) in the first year after transplantation, only one showing C4d positivity. Creatinine levels at 1 year after transplantation were similar: 1.5 mg/dL in the nonsensitized group versus 1.36 mg/dL in the sensitized group (P=0.6). CONCLUSION: Sensitization does not appear to have a significant negative impact on the survival of SLK patients.
Authors: M H Ravindranath; P I Terasaki; C Y Maehara; V Jucaud; S Kawakita; T Pham; W Yamashita Journal: Clin Exp Immunol Date: 2015-02 Impact factor: 4.330
Authors: Arnaud Del Bello; Olivier Thaunat; Moglie Le Quintrec; Oriol Bestard; Antoine Durrbach; Peggy Perrin; Philippe Gatault; Frederic Jambon; Georges-Philippe Pageaux; Laura Llado; Camille Besch; Louise Barbier; Martine Neau-Cransac; Jérôme Dumortier; Nassim Kamar Journal: Kidney Int Rep Date: 2020-10-03
Authors: J G O'Leary; A J Demetris; L S Friedman; H M Gebel; P F Halloran; A D Kirk; S J Knechtle; S V McDiarmid; A Shaked; P I Terasaki; K J Tinckam; S J Tomlanovich; K J Wood; E S Woodle; A A Zachary; G B Klintmalm Journal: Am J Transplant Date: 2014-03-01 Impact factor: 8.086
Authors: Flavio Paterno; Alin Girnita; Paul Brailey; David Witte; Jiang Wang; Madison C Cuffy; Tayyab Diwan; Simon Tremblay; Jane Y Revollo; Rita R Alloway; Michael R Schoech; Nadim Anwar; Shimul A Shah; Steve E Woodle Journal: Transplant Direct Date: 2016-11-23
Authors: Manon Dekeyser; Jean-Luc Taupin; Michelle Elias; Philippe Ichaï; Florence Herr; Marc Boudon; Melanie Brunel; Antonio Sa Cunha; Audrey Coilly; Faouzi Saliba; Antoine Durrbach Journal: Front Med (Lausanne) Date: 2022-08-22