Findings during assessment for LKT, patient selection, and transplantation outcome
Pt no. . | Duration of dialysis at assessment for LKT, mo . | CrCl, mL/s/m2 . | Autonomic neuropathy . | Echo findings (IVS and LVPW in mm) . | Coronary disease . | Systemic vascular disease . | LKT listing decision . | Duration of dialysis at LKT, mo . | ITU stay, d . | Hospital stay, d . | LKT outcome survival, mo . |
---|---|---|---|---|---|---|---|---|---|---|---|
1 | 0 | 0.38 | GI | Normal | None | None | Listed | 0 | 2 | 21 | Alive 74 |
2 | Failed 2nd Tx† | 0 | GI | Normal | None | None | Listed | 36 | 2 | 19 | Alive 155 |
3 | Failed 2nd Tx† | 0.45 | Cardiac, GI | Dilated LA | IHD | Aorta | Rejected | — | — | — | — |
4 | 42 | 0 | Cardiac, GI | EF 45%, IVS 13 | Previous MI | Iliac | Rejected | — | — | — | — |
5 | 36 | 0 | GI | Dilated RA, LA | IHD | Carotid | Rejected | — | — | — | — |
6 | 48 | 0 | GI | Normal | IHD | Carotid | Rejected | — | — | — | — |
7 | 0 | 0.86 | None | Normal | None | None | Listed | 0 | 12 | 21 | Alive 68 |
8 | 2 | 0.16 | GI | Normal | None | Femoral | Listed | 26 | 63 | 112 | Alive 33 |
9 | 0 | 0.26 | Cardiac, GI | Normal | IHD | None | Listed | 8 | 45 | 71 | Dead 2.5 |
10 | 26 | 0 | Cardiac, GI | Normal | None | Aorta | Listed | 34 | 35 | 40 | Dead 1.3 |
11 | 33 | 0 | Cardiac, GI | Normal | IHD, MI | Carotid | Listed | 42 | 43 | 91 | Alive 66 |
12 | 0 | 0.26 | GI | Normal | None | None | Listed | 4 | 2 | 18 | Alive 51 |
13 | 0 | 0.29 | Cardiac, GI | Normal | IHD | Carotid | Listed § | — | — | — | — |
14 | 0 | 0.16 | GI | EF 45%, LVH | IHD, MI | Iliac | Listed § | — | — | — | — |
15 | 0 | 0.29 | Cardiac | IVS, LVW 13 | IHD | None | Listed § | — | — | — | — |
16 | 0 | 0.55 | Cardiac | Restrictive | IHD | Carotid | Listed § | — | — | — | — |
17 | 0 | 0.26 | Cardiac | IVS 13, AV 18 | IHD | Aorta | Rejected | — | — | — | — |
18 | 0 | 1.03 | Cardiac | Dilated CMP | IHD | Carotid | Rejected | — | — | — | — |
19 | 0 | 0.15 | Cardiac | IVS, LVW 14 | None | None | Listed | 8 | 130 | 130 | Dead 4.3 |
20 | 0 | 0.86 | None | IVS, LVW 12.5 | MI-CABG | None | Rejected | — | — | — | — |
21* | 0 | 0.75 | GI | Wall akinesis* | MI-stent | None | Rejected | — | — | — | — |
22‡ | 0 | 1.16 | Cardiac, GI | Impaired relaxation | Mild | None | Listed | — | — | — | Awaiting LKT |
Pt no. . | Duration of dialysis at assessment for LKT, mo . | CrCl, mL/s/m2 . | Autonomic neuropathy . | Echo findings (IVS and LVPW in mm) . | Coronary disease . | Systemic vascular disease . | LKT listing decision . | Duration of dialysis at LKT, mo . | ITU stay, d . | Hospital stay, d . | LKT outcome survival, mo . |
---|---|---|---|---|---|---|---|---|---|---|---|
1 | 0 | 0.38 | GI | Normal | None | None | Listed | 0 | 2 | 21 | Alive 74 |
2 | Failed 2nd Tx† | 0 | GI | Normal | None | None | Listed | 36 | 2 | 19 | Alive 155 |
3 | Failed 2nd Tx† | 0.45 | Cardiac, GI | Dilated LA | IHD | Aorta | Rejected | — | — | — | — |
4 | 42 | 0 | Cardiac, GI | EF 45%, IVS 13 | Previous MI | Iliac | Rejected | — | — | — | — |
5 | 36 | 0 | GI | Dilated RA, LA | IHD | Carotid | Rejected | — | — | — | — |
6 | 48 | 0 | GI | Normal | IHD | Carotid | Rejected | — | — | — | — |
7 | 0 | 0.86 | None | Normal | None | None | Listed | 0 | 12 | 21 | Alive 68 |
8 | 2 | 0.16 | GI | Normal | None | Femoral | Listed | 26 | 63 | 112 | Alive 33 |
9 | 0 | 0.26 | Cardiac, GI | Normal | IHD | None | Listed | 8 | 45 | 71 | Dead 2.5 |
10 | 26 | 0 | Cardiac, GI | Normal | None | Aorta | Listed | 34 | 35 | 40 | Dead 1.3 |
11 | 33 | 0 | Cardiac, GI | Normal | IHD, MI | Carotid | Listed | 42 | 43 | 91 | Alive 66 |
12 | 0 | 0.26 | GI | Normal | None | None | Listed | 4 | 2 | 18 | Alive 51 |
13 | 0 | 0.29 | Cardiac, GI | Normal | IHD | Carotid | Listed § | — | — | — | — |
14 | 0 | 0.16 | GI | EF 45%, LVH | IHD, MI | Iliac | Listed § | — | — | — | — |
15 | 0 | 0.29 | Cardiac | IVS, LVW 13 | IHD | None | Listed § | — | — | — | — |
16 | 0 | 0.55 | Cardiac | Restrictive | IHD | Carotid | Listed § | — | — | — | — |
17 | 0 | 0.26 | Cardiac | IVS 13, AV 18 | IHD | Aorta | Rejected | — | — | — | — |
18 | 0 | 1.03 | Cardiac | Dilated CMP | IHD | Carotid | Rejected | — | — | — | — |
19 | 0 | 0.15 | Cardiac | IVS, LVW 14 | None | None | Listed | 8 | 130 | 130 | Dead 4.3 |
20 | 0 | 0.86 | None | IVS, LVW 12.5 | MI-CABG | None | Rejected | — | — | — | — |
21* | 0 | 0.75 | GI | Wall akinesis* | MI-stent | None | Rejected | — | — | — | — |
22‡ | 0 | 1.16 | Cardiac, GI | Impaired relaxation | Mild | None | Listed | — | — | — | Awaiting LKT |
LKT indicates liver and kidney transplantation; Cr Cr, creatinine clearance; Echo, echocardiography; IVS, intraventricular septum; LVPW, left ventricular posterior wall (thickness in millimeters); GI, gastrointestinal; EF, ejection fraction; CAGB, coronary artery bypass graft; MI, myocardial infarct; LA, left atrium; RA, right atrium; restrictive, restrictive physiology with impaired relaxation; IHD, ischemic heart disease; CMP, cardiomyopathy; and —, nonapplicable because the patients did not receive LKT.
Patient no. 21 underwent echocardiography in another facility and echo findings are excluded from analysis.
Both patients received hemodialysis at end-stage renal disease before kidney transplantation and for varying periods between subsequent failed kidney transplants.
Patient no. 22 was initially listed for preemptive isolated liver transplantation, but transplantation status was changed to listing for LKT when GFR fell below 50 mL/min during follow-up on the waiting list.
Patient nos. 13, 14, 15, and 16 were initially assessed as suitable candidates and were listed for LKT, but were removed from the waitlist due to deteriorating cardiac function or progressive IHD 11 to 34 months later.