The prognosis in a patient with liver and kidney disease is affected by the status of each dysfunctioning organ. It often makes sense to transplant both organs simultaneously.
Indications for a simultaneous liver-kidney (SLK) transplant:
Renal Status
Hepatic Status
end-stage renal disease (ESRD)
cirrhosis with either symptomatic portal hypertension or an hepatic vein wedge pressure gradient >= 10 mm Hg
chronic renal disease with GFR <= 30 mL per minute
end-stage liver disease (ESLD)
chronic renal disease with > 30% glomerulosclerosis on renal biopsy
end-stage liver disease (ESLD)
chronic renal disease with > 30% fibrosis on renal biopsy
end-stage liver disease (ESLD)
acute renal injury with creatinine >= 2 mg/dL AND on dialysis >= 8 weeks
end-stage liver disease (ESLD)
where:
• Dialysis for >= 8 weeks indicates that the patient's renal disease is now chronic.
• In the implementation ESRD was used in addition to chronic renal disease using the data in the table above.
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