Liver/Kidney (Combination) Transplantation
DESCRIPTION
A kidney transplant involves the surgical removal of a kidney from a cadaver, living-related, or unrelated donor and transplantation into a recipient.
A liver transplant is performed as a treatment of last resort for individuals with end-stage liver disease. End-stage liver failure manifestations include progressive jaundice, encephalopathy, variceal bleeding, spontaneous bacterial peritonitis, intractable ascites, intractable pruritus, and bleeding diathesis or coagulopathy.
POLICY
Combined liver-kidney transplantation is considered investigational.
See also:
ADDITIONAL INFORMATION
Scientific evidence in the form of published articles in peer-reviewed journals are lacking regarding selection criteria and outcomes of combination liver-kidney transplantation. Therefore, conclusions cannot be made concerning the effect of this technology on net health outcomes.
SOURCES
109th Congress: 1st Session: H. R. 1108: (2005, March). Liver research enhancement act of 2005. Retrieved January 10, 2006 from http://thomas.loc.gov.
109th Congress: 1st Session: H. R. 2051: (2005, May). Comprehensive immunosuppressive drug coverage for transplant patients act of 2005 (introduced in House). Retrieved January 10, 2006 http://thomas.loc.gov.
BlueCross BlueShield Association. Medical Policy Reference Manual. (6:2007). Kidney transplant (7.03.01). Retrieved April 15, 2008 from BlueWeb. (11 articles and/or guidelines reviewed)
BlueCross BlueShield Association. Medical Policy Reference Manual. (3:2007). Liver transplant (7.03.06). Retrieved November 30, 2007 from BlueWeb. (34 articles and/or guidelines reviewed)
Nakamura, M., Fuchinoue, S., Nakajima, I., Kitajima, K., Tojimbara, T., Takasaki, K., et al. (2001). Three cases of sequential liver-kidney transplantation from living-related donors. Nephrology Dialysis Transplantation, 16 (1), 166-168.
United Network of Organ Sharing. (2004, June). UNOS Organ distribution: Allocation of livers. Retrieved January 18, 2005 from http://www.optn.org/PoliciesandBylaws/policies/pdfs/policy_8.pdf.
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EFFECTIVE DATE |
4/16/2008 |
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ID_BT
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