Adoption of the model for end-stage liver disease score by Organ Procurement and Transplant Network(OPTN)deceased donor liver allocation policy in 2002 has led to an increase in the number of simultaneous liver kidney...Adoption of the model for end-stage liver disease score by Organ Procurement and Transplant Network(OPTN)deceased donor liver allocation policy in 2002 has led to an increase in the number of simultaneous liver kidney(SLK)transplantation.Since kidney function recovery following liver transplantation is difficult to predict,al ocation of the kidney for SLK trans-plantation thus far has not been based on much rationale and evidence.Lack of OPTN policy towards SLK organ allocation has resulted in great variations among transplant centers regarding SLK transplantation.Increasing use of kidneys towards SLK transplantation diverts deceased donor kidneys away from candidates awaiting kidney-alone transplantation.Recently OPTN/United Network of Organ Sharing has imple-mented medical eligibility criteria for adult SLK transplantation which also includes a concept of safety net.Implementation of the new policy is a move in a positive direction,providing consistency in our practice and evidence-based guidelines in selecting candidates for SLK transplantation.This policy needs to be monitored prospectively and modified based on new data that wil emerge over time.This review outlines the literature on SLK transplantation and efforts towards developing rational policy on SLK organ allocation.展开更多
文摘Adoption of the model for end-stage liver disease score by Organ Procurement and Transplant Network(OPTN)deceased donor liver allocation policy in 2002 has led to an increase in the number of simultaneous liver kidney(SLK)transplantation.Since kidney function recovery following liver transplantation is difficult to predict,al ocation of the kidney for SLK trans-plantation thus far has not been based on much rationale and evidence.Lack of OPTN policy towards SLK organ allocation has resulted in great variations among transplant centers regarding SLK transplantation.Increasing use of kidneys towards SLK transplantation diverts deceased donor kidneys away from candidates awaiting kidney-alone transplantation.Recently OPTN/United Network of Organ Sharing has imple-mented medical eligibility criteria for adult SLK transplantation which also includes a concept of safety net.Implementation of the new policy is a move in a positive direction,providing consistency in our practice and evidence-based guidelines in selecting candidates for SLK transplantation.This policy needs to be monitored prospectively and modified based on new data that wil emerge over time.This review outlines the literature on SLK transplantation and efforts towards developing rational policy on SLK organ allocation.
