Kidney allograft survival outcomes in combined intestinal‐kidney transplant: An analysis of the UNOS UNOS / OPTN OPTN database 2000‐2014

摘要

Abstract Background and objectives Intestinal transplants carry a high morbidity/mortality. Kidney allograft outcomes after combined intestinal ( IT ) with kidney transplant ( CIKT ) remain largely uninvestigated. Materials and methods The UNOS STAR database was queried to identify all such combined organ transplants from 2000 to 2015. Results Out of a total 2215 (51.4% peds vs 48.6% adults) intestinal transplants, 111 (5.0%) CIKT were identified (32.4% peds vs 67.6% adults). Over the study period of CIKT , a total of 45.9% of these cases died with a functioning kidney graft. DGF rate was 9.0%. The 1‐year reported kidney acute rejection rate was 6.3%. For the entire CIKT population over the entire study era, the 1‐, 3‐, and 5‐year unadjusted kidney graft survival was 57%, 39%, and 34%, while death‐censored kidney graft survival was 93%, 90%, and 86%, respectively. Overall conditional 5‐year kidney graft survival (defined as 1‐year kidney graft survival) was 58%. Overall, patient survival was significantly lower in recipients of CIKT compared to intestinal transplant ( IT ) ( P ??.005); However, the 5‐year conditional (1?year kidney graft) patient survival in adults was not significantly different between IT and CIKT overall ( P ?=?.194). Conclusions Kidney allograft survival is primarily dependent on 1‐year patient survival. Guidelines regarding allocation of kidney allografts in CIKT need to take into consideration utility and urgency.