Disclosures: The following people have nothing to disclose: Joel P. Wedd, Jane Gralla, Betsy Gans, Sue Dunn, Harvey Solomon, Michael D. Voigt, Scott W. Biggins Introduction: Over the last several years, the number of deceased donor simultaneous Liver-Kidney transplants (SLK) has

increased. However, guidelines for SLK, including when these combined organ transplants are appropriate based on serum creatinine, underlying liver and renal disease, etiology of renal dysfunction and time on dialysis are contentious. Inappropriate SLK removes an organ from the donor pool which would more appropriately be utilized for a patient awaiting kidney transplantation, and failure to provide SLK to a patient who requires prolonged dialysis and kidney transplantation following isolated LT is similarly inappropriate. We hypothesize that Akt inhibitor the use of SLK varies by region, and is unrelated

to mean MELD at the time of transplantation. Our group has previously presented data related to SLK transplants performed between 2002-2010. This data set is herein augmented with additional results from 2011 and 2012. Methods: Utilizing data provided by UNOS, we performed a retrospective review of all SLK performed from 2002-2012, analyzed the percentage of SLK performed in each region based on total number of liver selleck chemicals llc transplants (LT) performed, the ratio of % SLK performed to mean MELD at the time of transplantation, and assessed rate of change in number of SLK by year by region. Results: During this time period, 3,865 SLK and 56, 693 isolated LT were performed. Nationally, the ratio of SLK to LT was 6.7%. This ratio was dramatically different when comparing regions, with the highest ratio in regions 7, 1, and 5 (13, 10, and 9% respectively) and lowest in regions 6, 9, and

11 (3.4, 4.1, and 4.3%). The mean increase per year in number of SLK performed was 22, but also varied dramatically Tolmetin by region, with an increase of 52, 50 and 35 transplants in regions 3, 7, and 5 respectively, and −3, 1, and 2 in regions 1, 6, 8. When analyzing the ratio of % of SLK versus total LT to mean MELD score at the time of transplantation in each region, significant differences were also found, with the highest ratios in regions 7 and 1 (.394, .324) and lowest in regions 9, 6 and 11(.126, .128, .162). Conclusions: 1) Utilization of SLK varies significantly when comparing UNOS regions 2) The increased utilization of SLK does not appear to correlate to increased wait list MELD score at the time of transplantation in regions performing the highest % of SLK. In fact, lowest utilization of SLK is occurring in regions with some of the highest wait list MELD scores. 3) These findings suggest that a uniform policy related to utilization of SLK should be adopted Disclosures: Paul J.