Renal Graft Survival Post Thoracic and Abdominal Transplant: A Single Center Experience
University of Pittsburgh, Pittsburgh, PA
Meeting: 2013 American Transplant Congress
Abstract number: D1661
Introduction: ESRD is a common complication in patients with non-renal solid organ transplantation and such patients are living longer to receive kidney transplants. There is limited data on renal graft outcomes in these patients. With large volume of non-renal solid organ transplants at our center, we specifically looked at differential renal graft survival between previous thoracic and abdominal transplant recipients.
Methods: We retrospectively reviewed registry data available for patients who underwent renal transplantation following heart, lung, pancreas and liver transplant at UPMC over a 10 year period from Jan 2000- Dec 2011. The heart and lung recipients were categorized as thoracic (N=64) while isolated pancreas and liver recipients were categorized as abdominal (N=100) transplant groups. The continuous and categorical variables in the two groups were compared using ANOVA and chi-sq, respectively. We compared graft survival and death censored renal graft survival generating Kaplan Meier survival curves between thoracic and abdominal transplant groups. All p-values <0.05 were considered significant.
Results: The demographic and transplant specific details of the donors and recipients in each group are summarized in table 1. The median follow up time was 82 months. There was a statistically significant difference between renal graft survival curves of the two groups in favor of thoracic transplant recipients (p=0.004). Five year graft survival in thoracic transplant recipients was noted to be 90.6% compared to 72% in abdominal transplant recipients.
Conclusion: In our single center study, we noted a better renal transplant graft survival after thoracic (lung or heart) transplant as compared to abdominal (liver or pancreas) transplant recipients.
| Variables | Thoracic (N=64) | Abdominal (N=100) |
| Recipient | ||
| Age (Mean, Yrs) | 57 | 56 |
| Sex (M:F) | 48(75%):16(25%) | 62(62%):38(38%) |
| Race (N, %) | ||
| White | 60,93.8% | 90,90% |
| AA | 4,6.3% | 4,4% |
| Other | 0, 0% | 6,6% |
| Donor | ||
| Age (Mean, Yrs) | 40 | 38 |
| Sex (M:F) | 33(51.6%):31(48.4%) | 54(54%):46(46%) |
| Race (N, %) | ||
| White | 58,90.6% | 89,89% |
| AA | 4, 6.3% | 4,4% |
| Other | 2, 3.1% | 7,7% |
| Transplant | ||
| Induction (N, %) | ||
| Campath | 49,76.5% | 60,60% |
| Thymoglobulin | 0, 0% | 4,4% |
| Other | 15,23% | 13,13% |
| CIT (Mean, Min) | 1032 | 1038 |
| DGF (Y:N) | 9(14.1%):55(85.9%) | 14(14%):86(86%) |
| Donor Type (N, %) | ||
| Living | 22,34.3% | 30,30% |
| DBD | 41,64.0% | 62,62% |
| DCD | 1,1.5% | 7,7% |
| ACR at 6 mos (Y:N) | 4(6.3%):69(93.8%) | 20(20%):80(80%)* |
| ACR at 12 mos (Y:N) | 6(9.4%):58(90.6%) | 27(27%):73(73%)* |
| PRA | 3% | 4% |
| Interval b/w Transplants (Mean Days) | 3056 |
