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.
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.
Authors: J R Cassuto; P P Reese; S Sonnad; R D Bloom; M H Levine; K M Olthoff; A Shaked; A Naji; P Abt Journal: Am J Transplant Date: 2010-11 Impact factor: 8.086
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Authors: Asishana A Osho; Anthony W Castleberry; Laurie D Snyder; Asvin M Ganapathi; Sameer A Hirji; Mark Stafford-Smith; Shu S Lin; R Duane Davis; Matthew G Hartwig Journal: Ann Thorac Surg Date: 2014-05-01 Impact factor: 4.330
Authors: Asishana A Osho; Anthony W Castleberry; Laurie D Snyder; Scott M Palmer; Asvin M Ganapathi; Sameer A Hirji; Shu S Lin; R Duane Davis; Matthew G Hartwig Journal: Ann Thorac Surg Date: 2014-10-17 Impact factor: 4.330
Authors: Timothy J George; George J Arnaoutakis; Claude A Beaty; Matthew R Pipeling; Christian A Merlo; John V Conte; Ashish S Shah Journal: Ann Thorac Surg Date: 2012-02-10 Impact factor: 4.330
Authors: B E Lonze; D S Warren; Z A Stewart; N N Dagher; A L Singer; A S Shah; R A Montgomery; D L Segev Journal: Am J Transplant Date: 2009-03 Impact factor: 8.086
Authors: Nadine Al-Naamani; Omar H Maarouf; Vivek N Ahya; David J Lederer; James D Mendez; Jessie S Wilt; Alden M Doyle; Debbie Rybak; Frank D'Ovidio; Joshua R Sonett; Selim M Arcasoy; Thomas L Nickolas; Steven M Kawut Journal: J Heart Lung Transplant Date: 2008-04-23 Impact factor: 10.247