Long-term survival following kidney transplantation in previous lung transplant recipients-An analysis of the unos registry.

Published

Journal Article

BACKGROUND: Kidney transplantation has been advocated as a therapeutic option in lung recipients who develop end-stage renal disease (ESRD). This analysis outlines patterns of allograft survival following kidney transplantation in previous lung recipients (KAL). METHODS: Data from the UNOS lung and kidney transplantation registries (1987-2013) were cross-linked to identify lung recipients who were subsequently listed for and/or underwent kidney transplantation. Time-dependent Cox models compared the survival rates in KAL patients with those waitlisted for renal transplantation who never received kidneys. Survival analyses compared outcomes between KAL patients and risk-matched recipients of primary, kidney-only transplantation with no history of lung transplantation (KTx). RESULTS: A total of 270 lung recipients subsequently underwent kidney transplantation (KAL). Regression models demonstrated a lower risk of post-listing mortality for KAL patients compared with 346 lung recipients on the kidney waitlist who never received kidneys (P<.05). Comparisons between matched KAL and KTx patients demonstrated significantly increased risk of death and graft loss (P<.05), but not death-censored graft loss, for KAL patients (P = .86). CONCLUSIONS: KAL patients enjoy a significant survival benefit compared with waitlisted lung recipients who do not receive kidneys. However, KAL patients do poorly compared with KTx patients. Decisions about KAL transplantation must be made on a case-by-case basis considering patient and donor factors.

Full Text

Duke Authors

Cited Authors

  • Osho, AA; Hirji, SA; Castleberry, AW; Mulvihill, MS; Ganapathi, AM; Speicher, PJ; Yerokun, B; Snyder, LD; Davis, RD; Hartwig, MG

Published Date

  • May 2017

Published In

Volume / Issue

  • 31 / 5

PubMed ID

  • 28295652

Pubmed Central ID

  • 28295652

Electronic International Standard Serial Number (EISSN)

  • 1399-0012

Digital Object Identifier (DOI)

  • 10.1111/ctr.12953

Language

  • eng

Conference Location

  • Denmark