Outcomes of Kidney Transplantation in Cystic Fibrosis

End Stage Renal Disease (ESRD) occurs more frequently in people with cystic fibrosis (PwCF) than in the general population. We describe the characteristics and outcomes of kidney transplantation in PwCF.

We used data from the US Renal Data System, a virtually compete registry of US persons with ESRD. We compared patient characteristics and patient and graft survival of PwCF with kidney transplant with those without cystic fibrosis (CF), and PwCF with and without kidney transplant. We used linear and logistic regression, multivariable models, and Kaplan-Meier and log-rank tests with stratification/binning by propensity scores.

Of PwCF and ESRD, 50.6% received their first kidney transplant. PwCF with transplant were younger and more likely to be female than those without. and had lower odds of diabetes and higher odds of complications of lung transplantation being the cause of ESRD. CF was associated with greater odds of a living donor graft. Median survival with a kidney transplant was 21.1 years for PwCF and 38.1 years for those without. Death-censored graft survival was 20.5 years for PwCF and 13.3 years for those without.

The demographic and disease profiles of PwCF and kidney transplant differed transplant recipients without CF. Diabetes was found less frequently, and complications of lung and other organ transplants found more frequently, to be the cause of ESRD in PwCF. Survival with a kidney transplant was shorter for PwCF but was substantial. Graft survival was longer for PwCF than those without. The diagnosis of CF should not exclude appropriate PwCF from consideration for kidney transplantation.