Long‐term survival following kidney transplantation in previous lung transplant recipients—An analysis of the unos registry. Issue 5 (17th April 2017)

• Record Type: Journal Article
• Authors: Osho, Asishana A.; Hirji, Sameer A.; Castleberry, Anthony W.; Mulvihill, Michael S.; Ganapathi, Asvin M.; Speicher, Paul J.; Yerokun, Babatunde; Snyder, Laurie D.; Davis, Robert D.; Hartwig, Mathew G.
• Is Part Of: Clinical transplantation. Volume 31:Issue 5(2017)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2017-04-17
• Subjects: kidney after lung transplantation -- kidney transplantation -- lung transplantation -- survival; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ctr.12953
• Languages: English
• ISSNs: 0902-0063

Abstract

Abstract: 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.