Kidney disease in non-kidney solid organ transplantation

Area of Science:

• Nephrology
• Transplantation Medicine
• Immunology

Background:

• Kidney disease, including acute kidney injury and chronic kidney disease (CKD), is a frequent complication following non-kidney solid organ transplantation (NKSOT).
• This complication arises from a combination of pre-, peri-, and post-transplant factors, some shared across solid organ transplantation (SOT) and others unique to specific transplant types.
• Kidney disease significantly impacts patient and allograft survival, necessitating a thorough understanding of its mechanisms and management.

Purpose of the Study:

• To review the existing literature on kidney disease occurring after NKSOT.
• To identify prevalent types of kidney disease and associated risk factors in NKSOT recipients.
• To summarize current management strategies aimed at mitigating kidney disease progression and improving outcomes.

Main Methods:

• A narrative review of full-text English-language studies was conducted.
• Literature search focused on kidney disease in the context of NKSOT.
• Data synthesis involved summarizing findings on prevalence, risk factors, and management.

Main Results:

• Kidney disease is a prevalent post-transplant complication, especially after intestinal and lung transplantation.
• Management strategies such as proteinuria control, calcineurin-inhibitor minimization, and timely nephrology referral show promise in counteracting CKD progression.
• Kidney disease after NKSOT is a critical factor in organ allocation and transplantation ethics.

Conclusions:

• Kidney disease following NKSOT is a significant clinical challenge with serious consequences.
• Proactive management in the peri-operative and post-transplant phases is crucial for preserving kidney function.
• Further research and multidisciplinary collaboration are essential to address this complication and enhance patient and allograft survival.