Assessing Survival Outcomes of Simultaneous Liver-Kidney Versus Liver Alone Transplantation in the Era of the 2017 OPTN Policy

Highlight

• Simultaneous liver-kidney transplantation (SLKT) improved survival only in patients with severe renal dysfunction (eGFR <30 mL/min/1.73 m2).
• For patients with pretransplant eGFR ≥30, liver transplantation alone (LTA) yielded comparable or superior survival outcomes versus SLKT.
• The 2017 OPTN policy and Safety Net reduced SLKT rates without adversely affecting posttransplant survival.
• These findings endorse a stage-specific allocation paradigm incorporating the Safety Net for post-liver transplant kidney allocation.