Korean J Transplant.  2022 Nov;36(Supple 1):S119. 10.4285/ATW2022.F-2393.

Feasible living donor liver transplantation for patients on chronic hemodialysis: a multicenter study in Eastern countries

• Furukawa K
• Hong SK
• Shimata K
• Ito S
• Toshima T
• Akamatsu N
• Kasahara M
• Ikegami T
• Lee KW

• KMID: 2535635
• DOI: http://doi.org/10.4285/ATW2022.F-2393

Abstract

Background
End-stage liver and kidney disease is an indication for simultaneous liver and kidney transplantation. However, in countries where deceased donor transplantation has not developed, patients on hemodialysis (HD) are forced to choose living donor liver transplantation (LDLT). We investigated the outcome of LDLT for patients on HD in a multinational survey.
Methods
A retrospective multinational survey was performed for patients on HD who underwent LDLT. The characteristics of donors and recipients, and short and long-term outcomes were analyzed excluding patients with kidney transplantation.
Results
From 2001 to 2021, 46 patients on HD underwent LDLT. Of these, eight patients underwent kidney transplantation after LDLT reaching 100% survival rate. In 37 patients with only LDLT, 14 (38%) patients developed posttransplant bleeding and the overall survival rate at 5 years was 56%. In multivariate analysis, low graft recipient weight ratio (<1%) (hazard ratio [HR], 2.98; 95% confidence interval [CI], 1.00–8.80; P=0.049) and HD duration (less than 4 months or more than 10 years) (HR, 3.83; 95% CI, 1.25–11.8; P=0.02) were independently poor predictors of the overall survival.
Conclusions
It is important to select patients considering graft size and HD duration for LDLT of patients on HD.