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Kidney and liver transplantation in high-risk patients is increasingly common. More patients are progressing to end-stage renal failure with serious comorbidities, such as diabetes mellitus and cardiovascular disease. In addition, life expectancies of the end-stage renal disease (ESRD) population in general and the dialysis population are increasing. Consequently, the average ages of kidney donors and recipients are rising. A number of factors define the high-risk liver transplant recipient, including multiorgan transplantation, use of expanded criteria donors (ECDs), obesity, hepatitis C virus (HCV)-related disease, and retransplantation. Understanding donor, recipient, and allograft factors that come together to define the high-risk transplant recipient is a necessary prerequisite to providing optimal patient care. The high-risk transplant recipient was the focus of discussions at the 8th Annual State of the Art ASTS Winter Symposium.
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