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Kidney allograft survival outcomes in combined intestinal‐kidney transplant: An analysis of the UNOS / OPTN database 2000‐2014
Author(s) -
Moinuddin Irfan,
Yaqub Muhammad Sohail,
Taber Tim,
Mujtaba Muhammad,
Sharfuddin Asif
Publication year - 2018
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.13213
Subject(s) - medicine , kidney , kidney transplantation , survival analysis , population , kidney transplant , survival rate , gastroenterology , urology , surgery , database , environmental health , computer science
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.