Kidney allograft survival outcomes in combined intestinal‐kidney transplant: An analysis of the UNOS/OPTN database 2000‐2014. Issue 4 (16th February 2018)

• Record Type: Journal Article
• Authors: Moinuddin, Irfan; Yaqub, Muhammad Sohail; Taber, Tim; Mujtaba, Muhammad; Sharfuddin, Asif
• Is Part Of: Clinical transplantation. Volume 32:Issue 4(2018)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2018-02-16
• Subjects: allograft -- combined -- intestine -- kidney -- multivisceral -- rejection -- transplantation; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ctr.13213
• Languages: English
• ISSNs: 0902-0063

Abstract

Abstract: Background and objectives: Intestinal transplants carry a high morbidity/mortality. Kidney allograft outcomes after combined intestinal (IT) with kidney transplant (CIKT) remain largely uninvestigated. Materials and methods: The UNOS STAR database was queried to identify all such combined organ transplants from 2000 to 2015. Results: Out of a total 2215 (51.4% peds vs 48.6% adults) intestinal transplants, 111 (5.0%) CIKT were identified (32.4% peds vs 67.6% adults). Over the study period of CIKT, a total of 45.9% of these cases died with a functioning kidney graft. DGF rate was 9.0%. The 1‐year reported kidney acute rejection rate was 6.3%. For the entire CIKT population over the entire study era, the 1‐, 3‐, and 5‐year unadjusted kidney graft survival was 57%, 39%, and 34%, while death‐censored kidney graft survival was 93%, 90%, and 86%, respectively. Overall conditional 5‐year kidney graft survival (defined as 1‐year kidney graft survival) was 58%. Overall, patient survival was significantly lower in recipients of CIKT compared to intestinal transplant (IT) ( P < .005); However, the 5‐year conditional (1 year kidney graft) patient survival in adults was not significantly different between IT and CIKT overall ( P = .194). Conclusions: Kidney allograft survival is primarily dependent on 1‐year patient survival. Guidelines regarding allocation of kidney allografts in CIKT need to take into consideration utility and urgency.