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)|
|Age (Mean, Yrs)||57||56|
|Race (N, %)|
|Age (Mean, Yrs)||40||38|
|Race (N, %)|
|Induction (N, %)|
|CIT (Mean, Min)||1032||1038|
|Donor Type (N, %)|
|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%)*|
|Interval b/w Transplants (Mean Days)||3056|