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Renal event outcomes in intestinal transplantation: results from a single-center experience.

Abstract：

BACKGROUND:Poor patient outcomes have been closely linked with perioperative renal function after most solid organ transplants, except intestinal transplantation (ITx). This study examined the effect of peri-ITx renal function on outcome. PATIENTS AND METHODS:A retrospective review of all patients undergoing ITx since 1991 was completed and included 43 patients and 49 transplants. Serum creatinine (sCr) and calculated glomerular filtration rate were compared with peri-ITx and out to 5 years. A renal event (RE) was defined as acute renal failure, immunotherapeutic change driven by poor renal function, or hemodialysis. Comparisons were made based on primary immunotherapeutic regimens-induction interleukin-2 receptor antagonist (IL-2RA; n=31) or standard tacrolimus-based therapy (STD; n=18). Data was analyzed using standard statistical analysis. RESULTS:The frequency of RE was: 60% (STD) versus 31% (IL-2RA) P<.05. RE-associated mortality was 63% (STD) and 27% (IL-2RA) P<.05. Overall mortality was associated with a RE in 50% (STD) and 37% (IL-2RA) of patients. Average sCr across all timepoints was 1.05 (STD) and 0.78 (IL-2RA) P<.003. Surviving patients with RE in STD tended to suffer prolonged renal insufficiency, whereas those in IL-2RA did not. CONCLUSION:This is the first study examining outcomes after ITx related to renal function. Clearly, renal function and RE impacted outcomes. Obtaining RE-free survival and lessening the impact of RE when they do occur is of paramount importance. It appears that IL-2RA immunotherapy reduces RE and their associated morbidity.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Kaldas F,Farmer D,Gordon SA,McDiarmid SV,Venick R,Colangelo J,Busuttil RW

doi

10.1016/j.transproceed.2007.04.031

subject

Has Abstract

pub_date

2007-12-01 00:00:00

pages

3387-8

issue

10

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(07)01142-6

journal_volume

39

pub_type

杂志文章

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