Peritoneal Dialysis Is Feasible as a Bridge to Combined Liver-Kidney Transplant

Area of Science:

• Nephrology
• Hepatology
• Transplantation

Background:

• Patients with combined liver and kidney failure often require long-term dialysis while awaiting simultaneous liver-kidney transplantation (SLKT).
• The utility of peritoneal dialysis (PD) in this specific patient population remains underexplored.

Purpose of the Study:

• To evaluate the safety and efficacy of PD as a bridging therapy for patients with combined liver and kidney failure awaiting SLKT.
• To assess key outcomes including mortality, transplantation rates, and PD-related complications.

Main Methods:

• Retrospective review of medical and dialysis records for patients initiated on PD between 2006 and 2016 with combined liver and kidney failure.
• Analysis of outcomes such as mortality, SLKT status, hospitalizations, need for large-volume paracentesis (LVP), peritonitis rates, PD treatment duration, and albumin levels.

Main Results:

• Twelve patients with combined liver and kidney failure were treated with PD.
• No patient deaths occurred; three patients successfully received SLKT.
• No large-volume paracentesis (LVP) was required post-PD initiation.
• The peritonitis rate was low at 0.2 events per patient-year, predominantly caused by coagulase-negative Staphylococcus.

Conclusions:

• Peritoneal dialysis (PD) serves as a safe and effective bridging therapy for patients with advanced liver and kidney failure awaiting SLKT.
• PD can help manage fluid overload without the need for frequent large-volume paracentesis.
• Further research into PD's role in pre-transplant cirrhotic patients is warranted.