Risk factors for native kidney dysfunction in patients with abdominal multivisceral/small bowel transplantation

Area of Science:

• Nephrology
• Transplant Surgery
• Immunology

Background:

• Kidney dysfunction is a significant complication following non-renal solid organ transplantation, especially intestinal transplantation.
• Assessing risk factors is crucial for managing post-transplant kidney health.

Purpose of the Study:

• To identify risk factors associated with kidney dysfunction after intestinal transplantation.
• To analyze the impact of various clinical parameters on long-term kidney function.

Main Methods:

• Retrospective review of 33 multivisceral transplant (MVT) and 15 isolated small bowel (ISB) transplant patients.
• Kidney function assessed using MDRD and Schwartz formulas; acute kidney injury (AKI) defined by twofold increase in serum creatinine.
• Linear regression analysis to identify correlations with one-year post-transplant estimated GFR (eGFR).

Main Results:

• Kidney function declined significantly by one year post-transplant, with 46% of patients exhibiting eGFR <60 mL/min.
• Patients with AKI episodes were more likely to have reduced eGFR.
• Age, pre-transplant serum creatinine, early post-operative eGFR, and tacrolimus levels at post-operative day 7 correlated with one-year eGFR.

Conclusions:

• Key risk factors for post-transplant kidney dysfunction in intestinal transplant recipients include age, pre-transplant kidney function, AKI occurrence, and early post-operative eGFR.
• Pediatric patients and MVT recipients showed better kidney function preservation compared to adults and ISB recipients.
• Early identification and management of these risk factors are essential for improving outcomes in intestinal transplant patients.