PKD is the fourth cause of ESRD and accounts for 13% of yearly kidney transplants in the US. Our goal is to use an established cohort of PKD individuals evaluated for transplant to characterize their disease severity, transplant characteristics, transplant-related complications and outcomes.
We completed a retrospective analysis of all PKD patients who presented for transplant evaluation at the Emory Transplant Center between 1/1/2002 and 1/1/2012. Multiple medical databases were used to collect the data including organ transplant tracking record (OTTR). Demographics, medical conditions and PKD related complications were reported. We now provide the characteristics of the PKD patients who completed a transplant.
294 patients with PKD were evaluated. 173/294 (58.8%) were transplanted. 82 (27.9%) were listed but not yet transplanted and 39 (13.3%) were ineligible. Average age at the time of activation was 51.9 +/- 9.9 years. Average age at transplantation was 53 +/- 10.0 years. 86 (49.7%) of patients transplanted were male, 136 (78.6%) Caucasian, and 53 (30.6%) preemptive. 65 (37.5%) underwent living donor transplantation of which 24 (36.9%) were related. Non-pre-emptive transplant occurred in patients who received 2.98 +/- 2.7 years of dialysis prior to transplant (69.2% hemodialysis, 30.8% peritoneal dialysis). At transplant, 168 (97.0%) were hypertensive, 73 (42.0%) had hypercholesterolemia, and 75 (43.4%) had abdominal hernias. A total of 50 abdominal hernias were repaired prior to transplant: 10(20.0%) ventral, 21(42.0%) inguinal and 19(38.0%)umbilical. Patients had gastroesophageal reflux disease (GERD) 67 (39.0%), cardiovascular disease 47 (20.0%), gout 25 (14.5%) and diabetes 9 (5.0%).
This PKD transplant population is relatively severely affected with an average age of transplant 5 years earlier than the national average age of initiation of ESRD (55.5 years, USRDS), with a greater rate of preemptive transplant (30.6%) as compared to the preemptive rate (16.5%) for the general transplant population as reported by the SRTR. 36.9% of living donors were related vs. 58.6% nationally, potentially secondary to fewer eligible family members. This PKD population also has a unique medical profile with a relatively high rate of GERD (39.0%) and hernias (43.4%) but low rate of diabetes (5%).
To cite this abstract in AMA style:Chami A, Mittal A, Chapman A. Autosomal Dominant Polycystic Kidney Disease (PKD) Evaluated for Renal Transplantation. A Single Center Experience at Emory Transplant Center [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/autosomal-dominant-polycystic-kidney-disease-pkd-evaluated-for-renal-transplantation-a-single-center-experience-at-emory-transplant-center/. Accessed December 6, 2019.
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