*Purpose: Induction regimens for kidney transplant alone (KT) in lung recipients vary widely among transplant centers. We sought to examine the impact of kidney induction type on kidney graft and patient survival in KT recipients with a previous lung transplant utilizing the Scientific Registry of Transplant Recipients (SRTR).

*Methods: We analyzed data for adult primary KT recipients who received their kidney on or before 12/31/2015. Within this group we selected those who had a previous lung transplant. The induction type used before the kidney engraftment grouped recipients into 3 groups: depletional, non-depletional, and steroids only (those with non-standard induction regimens were excluded). Kaplan-Meier curves were produced to show patient survival and kidney graft survival following kidney transplant, stratified by kidney induction. Multivariate analysis was performed using a Cox proportional hazards model, with transplant center as a random effect. This model was further adjusted for lung induction, recipient and donor age, time from lung to kidney transplant, cause of lung disease, bilateral vs. single lung transplant and diabetes at the time of kidney transplant.

*Results: There were 364 adult primary kidney recipients with a previous lung transplant (KTAL) in our cohort. Of these 127 received depletional induction, 182 received non-depletional induction, and 55 received steroids only. There was no difference in death-censored kidney allograft survival (figure 1) or recipient survival by kidney induction type (figure2). Results were similar in the Cox proportional hazards model.

*Conclusions: Type of kidney induction did not influence patient or kidney graft survival following kidney transplant for those with a previous lung transplant. Non-depletional or steroid alone regimens should be the preferred choice given the higher cost and increased risk of infection associated with depletional regimens.

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