Background: Intestinal transplants (isolated/modified/multi-visceral) carry a high morbidity and mortality. Kidney outcomes after combined intestinal (IT) with kidney transplant (CIKT) remain largely uninvestigated.

Methods: The UNOS database was queried to identify all such combined organ transplants from 2000-2014.

Results: Out of a total 2,117 (51.8% peds vs 48.2% adults) intestinal transplants, 108 (5.1%) CIKT were identified (33.3% peds vs 66.7% adults). For the CKIT group, the mean donor age was 16.3+/-15.5 with a median KDPI of 34%, while mean recipient age was 33.3+/-22.1 ; 53.7% were males; 77.8% Whites; 25.9% on dialysis at the time of CIKT with median wait time of 36.5 days, while 27.8% of kidneys were en-bloc kidneys. Mean HLA mismatch was 4.6+/-1.0.

Over the study period of CIKT a total of 44.4% of these cases died with a functioning kidney graft. DGF rate was 9.3 %. The 1 year reported Kidney Acute rejection rate was 5.6%.

For the entire CIKT population over the entire study era the 1,3 & 5 year unadjusted kidney graft survival was 59%,43% and 39%, while death-censored kidney graft survival was 89%, 86% and 86% respectively. Overall conditional 5 year kidney graft survival (defined as 1yr kidney graft survival) was 65%.

Kaplan Meier kidney survival analysis for actuarial or conditional survival was not significantly different between the adult and pediatric recipients.

There was no difference in actuarial or conditional kidney survival between the two eras (2000-2006; n=30) vs (2007-2014; n=78).

Actuarial overall patient survival was significantly lower in recipients of CIKT compared to IT (p<0.005) which didn't change over the two time eras. Actuarial patient survival in the pediatric group and between two eras between IT and CKIT was similar (p=0.227). Overall Adult only actuarial patient survival was significantly improved in the latter time era (2007-2014; p=0.007). However in the recent era (2007-2014), the adult patient survival was significantly lower in patients who had received a CIKT compared to IT (p<0.0005). The conditional (1yr kidney graft) patient survival in adults was not significantly different between IT and CIKT, overall (p=0.194) or between the two eras (p=0.89).

Conclusions: We here report a detailed analysis of kidney survival outcomes in combined intestinal-kidney transplants, indicating that kidney outcomes are primarily dependent on 1 year patient mortality.

CITATION INFORMATION: Sharfuddin A, Taber T, Yaqub M, Moinuddin I, Khalil A, Adebiyi O, Mujtaba M. Kidney Survival Outcomes in Combined Intestinal-Kidney Transplant: An Analysis of the UNOS/OPTN Database 2000-2014. Am J Transplant. 2016;16 (suppl 3).

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