ArticleTransplant international : official journal of the European Society for Organ Transplantation2021
Simultaneous liver kidney allocation policy and the Safety Net: an early examination of utilization and outcomes in the United States.
Article in Transplant international : official journal of the European Society for Organ Transplantation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Revisiting national allocation policies for combined liver transplantation in light of the delayed allocation approach.Updates in surgery · 2026Article
- Effect of Pre-Transplant Sensitization on Kidney Allograft Survival Following Simultaneous Liver and Kidney Transplantation: A Decade of Experience from an Academic Transplant Center.Clinical transplantation · 2026Article
- Kidney safety net utilization after liver transplant for acute alcohol-associated hepatitis.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2026Article
- Outcomes of Simultaneous Liver-Kidney Transplant and Kidney After Liver Transplant Using the Safety Net Criteria-A Single-center Experience.Transplantation direct · 2026Article
- Kidney allograft outcomes in combined kidney with other solid organ transplantation.World journal of transplantation · 2026Review
- Safety Net kidney after liver transplantation: unexpected renal recovery in a liver transplant recipient after more than 10 months on maintenance hemodialysis - a case report.Frontiers in nephrology · 2026Article
- Simultaneous Liver-Kidney Transplantation versus Liver Transplantation in End-Stage Liver Disease Patients with Kidney Dysfunction.European surgical research. Europaische chirurgische Forschung. Recherches chirurgicales europeennes · 2026Article
- Racial disparities in posttransplant outcomes among recipients undergoing simultaneous liver-kidney transplantation.European journal of gastroenterology & hepatology · 2025Article
- Deceased Donor Renal Allograft Utility in Adult Single and Multi-organ Transplantation in the United States.Transplantation direct · 2025Article
- Simultaneous Liver and Kidney Transplantation in Patients Aged 70 y and Older: Proceed With Caution.Transplantation direct · 2024Article
- Current status of simultaneous liver-kidney transplantation.Hepatology forum · 2024Review
- Acute kidney injury in patients with acute-on-chronic liver failure: clinical significance and management.Kidney research and clinical practice · 2023Article
- The Effect of New Acuity Circle Policy on Simultaneous Liver and Kidney Transplantation in the United States.Journal of clinical and experimental hepatologyArticle
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Authors and funding
10 authors.
Funding
Abstract
Rates of simultaneous liver kidney (SLK) transplantation in the United States have progressively risen. On 8/10/17, the Organ Procurement and Transplantation Network implemented a policy defining criteria for SLK, with a "Safety Net" to prioritize kidney allocation to liver recipients with ongoing renal failure. We performed a retrospective review of the United Network for Organ Sharing (UNOS) database to evaluate policy impact on SLK, kidney after liver (KAL) and kidney transplant alone (KTA). Rates and outcomes of SLK and KAL transplants were compared, as was utilization of high-quality kidney allografts with Kidney Donor Profile Indices (KDPI) <35%. Here, SLK transplants comprised 9.0% and 4.5% of total postpolicy liver and kidney transplants compared to 10.2% and 5.5% prior. Policy enactment did not affect 1-year graft or patient survival for SLK and KAL populations. Less postpolicy SLK transplants utilized high-quality kidney allografts; in all transplant settings, outcomes using high-quality grafts remained stable. These findings suggest that policy implementation has reduced kidney allograft use in SLK transplantation, although both SLK and KAL rates have recently increased. Despite decreased high-quality kidney allograft use, SLK and KAL outcomes have remained stable. Additional studies and long-term follow-up will ensure optimal organ access and sharing.
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