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

Asishana A. Osho, Sameer A. Hirji, Anthony W. Castleberry, Michael S. Mulvihill, Asvin M. Ganapathi, Paul J. Speicher, Babatunde Yerokun, Laurie D. Snyder, Robert D. Davis, Mathew G. Hartwig

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

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.

Original languageEnglish (US)
Article numbere12953
JournalClinical Transplantation
Volume31
Issue number5
DOIs
StatePublished - May 2017
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

Keywords

  • kidney after lung transplantation
  • kidney transplantation
  • lung transplantation
  • survival

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