Proceedings of Consensus Conference on Simultaneous Liver Kidney Transplantation (SLK)

Area of Science:

• Transplantation Medicine
• Nephrology
• Hepatology

Background:

• Simultaneous liver-kidney transplantation (SLK) is a complex procedure for patients with end-stage liver and kidney disease.
• Existing listing criteria for SLK lacked standardization, leading to variability in patient selection.
• A consensus conference involving major transplant societies addressed the need for unified SLK indications.

Framework:

• Proposed standardized listing criteria for SLK, focusing on MELD exceptions.
• Established the role of Regional Review Boards (RRBs) in determining SLK eligibility.
• Recommended specific criteria for automatic approval, including end-stage renal disease with cirrhosis and portal hypertension, or liver failure with advanced CKD.

Implementation:

• Leveraged data from the Scientific Registry of Transplant Recipients and single-center studies.
• Included data on chronic kidney disease (CKD) and acute kidney injury (AKI) in patients with liver failure.
• RRBs will evaluate all other SLK requests not meeting automatic approval criteria.

Implications:

• Aims to ensure equitable and appropriate selection of patients for SLK.
• Facilitates the establishment of a prospective data registry for SLK outcomes.
• Standardized criteria are expected to improve patient management and transplant program efficiency.