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In these cases, split allocation of the liver and kidney yields significantly more life-years. The threshold favoring split allocation of a kidney was a >50% chance of renal recovery after LTA. Although the specific results of a decision analysis (in this case, a 50% chance of renal recovery) should not be considered a definitive answer to a clinical problem, the study suggests that SLK transplant will provide net benefit compared to a kidney-alone transplant only when the risk of posttransplant ESRD after LTA is substantial. As in http://www.selleck.cn/products/AZD0530.html Figure 2, the risk of ESRD among individuals with weighted mean eGFR http://www.selleckchem.com/products/cx-5461.html reason, we believe that carefully selected Group 2d patients merit consideration for SLK. It is important to recognize that the posttransplant mortality rate far outstrips the rate of ESRD for patients in Group 1 and most patients in Group 2. Given this increased hazard of posttransplant mortality relative to ESRD, the http://www.selleckchem.com/products/forskolin.html overriding goal in managing these patients on the waiting list should be to obtain the optimal liver to minimize mortality risk. For these patients, the decision to take the offer of a LTA versus waiting for an SLK may also depend on the patient's age and the likely waiting time for a combined organ offer. Black race and lower albumin at transplantation were associated with a greater hazard of posttransplant ESRD. Black LTA recipients may develop ESRD at a more rapid rate than others due to recently described genetic factors as well as social reasons such as less education and less access to medical care (21,22). Recipients with lower albumin concentrations may be more chronically ill, thus having an eGFR that overestimates the true GFR due to diminished muscle mass. Lower albumin may also be a sign of proteinuria.