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Long‐term survival following kidney transplantation in previous lung transplant recipients—An analysis of the unos registry
Author(s) -
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.
Publication year - 2017
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12953
Subject(s) - medicine , transplantation , kidney transplantation , lung transplantation , kidney disease , kidney , proportional hazards model , lung , surgery
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 ( KT x). 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 KT x 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 KT x patients. Decisions about KAL transplantation must be made on a case‐by‐case basis considering patient and donor factors.