Acute kidney injury (AKI) is a frequent complication in critically ill patients admitted to Intensive Care Units, often complicated by high mortality and progression toward chronic kidney disease (CKD). Only few studies evaluated AKI incidence in non renal solid organ transplant (NRSOT) recipients. The aims of the present study were: 1) a 15-year retrospective analysis of AKI incidence in NRSOT; 2) to identify the impact of AKI on outcome and progression toward CKD.

We retrospectively analyzed (2000-2015) the percentage of NRSOT in the whole AKI population treated by renal replacement therapies (RRTs). RIFLE and SOFA scores and the severity index ATN_ISS at the start of RRT were evaluated. The percentage of AKI requiring dialysis in the whole NRSOT population and for single transplanted organ (liver, heart or lung graft) was studied. Renal function was evaluated at the end of the observation period (30 days). Hemer-Lemeshow statistical test was performed.

In the period 2000-2015, we treated by RRT 2756 critically ill patients with AKI for a total of 12416 sessions performed. Among this population, 402/2756 (14.6%) were NRSOT recipients. In the study period, we treated by RRT 10.8 % of all patients subjected to liver transplantation, 27.5% of heart transplanted patients and 26.2% of lung transplanted patients. NRSOT patients' characteristics were: age 59.2 yrs (SD 7.6), male 62.5%, serum creatinine 3.76 mg/dl (SD 1.34), number of organ failures 3.7 (SD 1.87) and ATN_ISS score 0.68 (SD 0.16). The prevalent cause of AKI in NRSOT patients was sepsis (52.5%), associated with high mortality, multiple organ failures and a difficult management of the immunosuppressive therapy. Overall mortality in NRSOT patients was 42.6% and in particular 38.5% for liver, 48% for heart and 41.5% for lung transplant recipients, respectively. Mean serum creatinine at the end of the study period was 2.43 mg/dl (2.06 mg/dl in liver, 2.42 mg/dl in heart and 2.82 mg/dl in l2.43 ung graft recipients, respectively).

In conclusion, our 15-year retrospective analysis revealed a continuous increase of AKI incidence in the NRSOT population. The main cause of AKI was sepsis which was associated with high mortality and with progression toward CKD in survivors.

CITATION INFORMATION: Cantaluppi V, Quercia A, Dellepiane S, Medica D, Biancone L. A 15-Year Retrospective Analysis of Acute Kidney Injury in Non Renal Solid Organ Transplant Recipients: Incidence, Outcome and Progression Toward End Stage Chronic Kidney Disease. Am J Transplant. 2016;16 (suppl 3).

« Back to 2016 American Transplant Congress