This article is more than 5 years old. Information may no longer be current.

Kidney rejection apparent in SLK recipients

Kidney rejection was common and not immune to the liver among patients who underwent simultaneous liver-kidney transplantation, or SLK, according to study data published in the Journal of Hepatology. 

“The assumption that the liver graft automatically confers full protection immunity toward other grafts is now well supported by literature,” the researchers wrote. “Clarity on the incidence, types and impact of rejection in SLK are needed, given the increasing number of kidneys being utilized for SLK. As our institution is located in a high MELD region and performs a significant number of SLK procedures, we had the ability to report these SLK outcomes and test these assumptions.”

Researchers from Northwestern University Feinberg School of Medicine evaluated data of 140 transplant recipients who underwent SLK at their center between 1998 and June 2010. The goal was to determine incidence and types of organ rejection, graft function and graft and patient survival, according to the research.

Overall, 18 patients experienced acute cellular or chronic liver rejection, nine experienced mild rejection, six experienced moderate rejection and one patient experienced severe rejection. Twelve patients experienced kidney rejection, including acute cellular rejection in nine patients and one patient experiencing moderate to severe rejection.

Overall patient survival rates were 86.4% at 1 year, 78% at 3 years and 74% at 5 years. No differences were seen in patient survival between patients who experienced any type of kidney rejection and those who did not (P = .26) or between those who experienced liver rejection of any type and those who did not (P = .72). During follow-up, three patients died due to liver graft failure.       

Patients who experienced acute cellular kidney rejection had lower glomerular filtration rate levels compared with patients without rejection (P = .003), indicating that kidney rejection was associated with decreased renal function as a result of low glomerular filtration rate levels over time, according to the research.

“We demonstrate that the liver provides less immunity against kidney rejection than previously believed, although it may be at least partially protective,” the researchers concluded. “Kidney rejection, both acute cellular and antibody-mediated, does occur in SLK recipients and may impact renal graft function over time.”

Disclosure: The researchers report no relevant financial disclosures.