Native kidney function after renal transplantation combined with other solid organs in preemptive patients

Area of Science:

• Nephrology
• Transplantation Immunology
• Organ Transplantation

Background:

• Combined organ transplantation, including liver-kidney (LKT) and heart-kidney (HKT), is rising.
• Lack of nephrologic guidelines for preemptive combined transplants in non-dialysis patients.
• Assessing native kidney function post-transplant is crucial.

Purpose of the Study:

• To evaluate the functional contribution of native kidneys after preemptive combined organ transplantation.
• To determine the role of native kidneys in patients undergoing LKT or HKT.
• To establish criteria for combined transplantation eligibility.

Main Methods:

• Retrospective analysis of 9 patients undergoing combined LKT (8) or HKT (1).
• Scintigraphic functional studies (Tc-99DMSA or Tc-99mMAG3) at 4 months post-transplant.
• Assessment of native and graft kidney function, patient, and graft survival.

Main Results:

• Transplanted kidneys provided an average functional contribution of 77% ± 18%.
• Native kidney function loss is a high risk in organic nephropathies.
• 100% patient and graft survival at 36 months post-transplant.

Conclusions:

• Preemptive combined transplantation shows excellent outcomes with significant graft function.
• Creatinine clearance <30 mL/min may be an appropriate cutoff for combined transplantation.
• Thorough pre-transplant assessment is vital to optimize organ utilization and patient selection.