Simultaneous Lung-Kidney Transplantation in the United States

Area of Science:

• Nephrology
• Pulmonology
• Transplant Surgery

Background:

• Simultaneous lung-kidney transplantation is a rare procedure.
• National trends and outcomes for this procedure are not well-documented.

Purpose of the Study:

• To analyze national practice trends and outcomes of simultaneous lung-kidney transplantation.
• To compare the survival and allograft outcomes of lung-kidney recipients with relevant control groups.

Main Methods:

• Utilized the United Network for Organ Sharing database (2005-2022).
• Identified 108 lung-kidney transplant recipients.
• Compared recipients with isolated lung recipients (dialysis/eGFR ≤30 or 30 < eGFR < 50) and recipients of contralateral kidneys from the same donor.

Main Results:

• Annual lung-kidney transplant volume increased significantly from 2005 to 2022.
• Lung-kidney recipients showed improved survival compared to isolated lung recipients with pretransplantation dialysis or eGFR ≤30 mL/min/1.73 m².
• No survival benefit was observed compared to isolated lung recipients with 30 < eGFR < 50 mL/min/1.73 m².
• Lung-kidney recipients had a higher risk of kidney allograft loss compared to recipients of contralateral kidneys from the same donor.

Conclusions:

• Simultaneous lung-kidney transplantation offers a survival advantage for patients with severe kidney impairment requiring dialysis.
• The procedure is associated with an increased risk of kidney allograft loss, often due to death with a functioning graft.
• Further research is needed to optimize outcomes for simultaneous lung-kidney transplant recipients.