Kidney allograft outcomes in combined kidney with other solid organ transplantation

With advances in solid organ transplantation, the option of combined kidney with other solid organ transplantation is an enticing option for patients with advanced kidney disease and concomitant other solid organ failure. Kidney allograft dysfunction is well known to be associated with increased adverse outcomes post solitary kidney transplant however, outcomes for patients and the kidney allograft are somewhat understudied in the setting of kidney transplantation when combined with other solid organ transplantation such as in a simultaneous liver-kidney transplant. We will provide an overview of the current literature available on kidney allograft clinical outcome measures in combined solid organ transplant recipients such as delayed kidney allograft function, kidney allograft rejection, kidney allograft and patient survival metrics and how they compare to patients with kidney transplants alone. Worse kidney allograft survival outcomes were noted in most combined other organ with kidney transplantation (liver-kidney, heart-kidney, and lung-kidney) due to comorbidities attributed to non-renal organ dysfunction whereas improved kidney allograft survival outcomes were noted for pancreas-kidney transplantation.