The evolution of kidney function after lung transplantation: a retrospective cohort study

Area of Science:

• Nephrology
• Pulmonology
• Transplantation Medicine

Background:

• Limited data exists on kidney function decline post-lung transplant.
• Assessing kidney function evolution is crucial for transplant management.

Purpose of the Study:

• To evaluate kidney function changes after lung transplantation.
• To identify a pre-transplant glomerular filtration rate (GFR) threshold for considering dual lung-kidney transplantation.

Main Methods:

• Retrospective, single-center cohort study of 241 lung transplant recipients.
• Glomerular filtration rate (GFR) measured pre-transplant and up to 10 years post-transplant using MDRD7 equation.
• Hierarchical linear regression model analyzed GFR changes over time.

Main Results:

• Mean pre-transplant GFR was 92 +/- 33 mL/min/1.73 m(2).
• GFR rapidly declined by 24 mL/min/1.73 m(2) in the first month and 34 mL/min/1.73 m(2) at 1 year post-transplant.
• Patients with baseline GFR <= 60 mL/min/1.73 m(2) experienced a 1-year GFR decline of 9 mL/min/1.73 m(2), followed by stabilization.

Conclusions:

• Kidney function significantly decreases within the first year after lung transplantation, then stabilizes.
• Dual lung-kidney transplantation should be considered for individuals with a baseline GFR of 35 mL/min/1.73 m(2) or lower.
• These patients may become eligible for kidney transplantation within 1-2 years post-lung transplant.