Simultaneous Prospective Kidney Transplant Assessment in Combined Liver Kidney Candidates

The purpose of the study is to determine how much a persons kidney function recovers after receiving a simultaneous liver kidney transplant. The investigators will be contacting patients with kidney dysfunction with estimated GFR between 25 and 40 (not on dialysis treatment) who are listed to receive a simultaneous liver kidney (SLK) transplant to look at this function recovery. The investigators hope to develop a criteria based on GFR measurement, kidney function calculations from native kidneys vs transplanted kidney and compare the contributions, and correlate with estimated GFR on basic metabolic panel (BMP: a blood test) to predict higher chances of recovery of native kidney function.

Inclusion Criteria:> 18 years oldListed for Liver Transplant for ESLD and Kidney Transplant (not on dialysis at time of transplant surgery)Candidates with two native kidneys.Willing to participate and sign informed consent form.Exclusion Criteria:Unstable patients (e.g. in the ICU or those who are on Continuous Renal Replacement Therapy (CRRT) who cannot complete the nuclear medicine scan or those with AKI on HemodialysisPrior history of any solid organ transplant.Those who are currently pregnant or breast feeding.Patients who have Autosomal Dominant polycystic kidney disease