Simultaneous Intestinal and Kidney Transplantation in Adults

Autor: Irum Amin, Charlotte Rutter, Adam Barlow, Neil K. Russell, J. Andrew Bradley, Andrew Jackson, Andrew J. Butler
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: Journal of Investigative Surgery, Vol 32, Iss 4, Pp 283-289 (2019)
Druh dokumentu: article
ISSN: 0894-1939
1521-0553
08941939
DOI: 10.1080/08941939.2017.1409849
Popis: Aim of the study: Intestinal transplantation (IT) is a life-saving procedure for carefully selected patients with intestinal failure. We evaluated patients who had undergone simultaneous intestinal and kidney transplantation (SIKT) to determine whether UK guidelines for inclusion of a renal allograft (dialysis dependent or estimated glomerular filtration rate ((eGFR)) < 45 ml/min/1.73 m2) are justified. Methods: A single centre analysis was undertaken of adults undergoing IT at the Cambridge Transplant Centre between December 2007 and January 2016. A prospectively maintained database was used to identify SIKT recipients and determine outcomes. Results: Over this period, 63 intestinal transplants were performed. Seven (11.1%) recipients received a SIKT. Five were pre-dialysis (median eGFR 29 ml/min/1.73 m2, range 16–36 ml/min/1.73 m2). One recipient was on dialysis, and one needed bilateral nephrectomy at transplant. There were no primary kidney allograft failures and at three months, the median eGFR (55 ml/min/1.73 m2 range 39–124) was similar to recipients of IT alone (median eGFR 56 ml/min/1.73 m2 range 17–143 ml/min/1.73 m2). Two recipients required dialysis due to sepsis related kidney injury and died from multi-organ failure (20 and 63 months). Two died with a functioning renal transplant (10 and 15 months). The remaining three patients are alive at follow up (12–96 months) with an eGFR of 20–45 ml/min/1.73 m2. Conclusion: Patients with significant renal impairment (eGFR
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