AI Article Synopsis

  • End-stage renal disease poses challenges for lung transplant patients, leading to the consideration of combined kidney-lung transplantation (CKLT) and kidney after lung transplantation (KALT) as potential solutions.
  • A study reviewing outcomes of 26 patients showed that CKLT had a 30-day and 1-year survival rate of 75.6%, while no KALT patients died during follow-up, highlighting KALT's safety.
  • The study found that kidney graft functions were similar between both strategies, but CKLT's success is significantly impacted by post-lung transplant complications, emphasizing the need for careful consideration of transplant options.

Article Abstract

BACKGROUND End-stage renal disease is a major issue in the management of patients undergoing lung transplantation. Combined kidney-lung transplantation (CKLT) and kidney after lung transplantation (KALT) are the 2 preferred solutions to manage this situation. To evaluate these strategies, we describe kidney and lung graft outcomes and patient survival in patients managed with CKLT and KALT. MATERIAL AND METHODS We conducted a retrospective single-center cohort study. Patients who underwent a CKLT or a KALT were included in this study. Retrospective extraction of data from medical records was performed. RESULTS Seventeen patients underwent CKLT and 9 underwent KALT. Most of the patients had cystic fibrosis and presented renal failure related to anti-calcineurin toxicity. The 30-day and 1-year survival of CKLT recipients were both 75.6%. No patients with KALT died during the follow-up. Kidney graft prognosis was almost exclusively influenced by patient survival in relation to postoperative lung transplant complications. The rate of severe surgical complications was close to 60% for CKLT compared with 30% for KALT. The kidney graft function (estimated kidney graft function) did not differ according to the transplantation strategy. CONCLUSIONS KALT is a safe option, with postoperative morbidity and renal graft function identical to those of kidney transplantation in non-lung-transplanted patients. The results of CKLT depend mainly on the morbidity associated with lung transplantation but remain an attractive option for patients with respiratory failure associated with end-stage renal disease. The choice of transplant strategy must also take into account the most ethical and efficient allocation of kidney grafts.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11346323PMC
http://dx.doi.org/10.12659/AOT.944049DOI Listing

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