#2935 Kidney transplantation outcomes following non-kidney solid organ transplantation

Abstract

Abstract Background and Aims Approximately 15% of recipients of non-kidney solid organ transplantation (NKSOT) develop end-stage chronic kidney disease (CKD), requiring kidney transplantation (KT). There are controversy whether KT after NKSOT outcomes are poor or whether these patients should be prioritized. Method Retrospective analysis of KT after NKSOT in Andalusia between 1978-2023. We performed a case-control study, choosing 2 controls for each case (1 recipient of a second KT [reKT] and 1 recipient of a first KT without previous NKSOT), the closest ones with KT date and similar age and gender between donor and recipient. Patients with renopancreatic transplantation were excluded. We compared clinical characteristics and outcomes. Results During this period, we followed 12217 KT in Andalusia. Of these, 35 (0.003%) are KT after NKSOT: 26 (74.3%) liver transplant recipients, 7 (20%) heart transplant recipients and 2 (5.7%) lung transplant recipients. All of them are recipients of a first KT. When comparing KT after NKSOT vs. reKT and first KT recipients, demographic characteristics and donor type are similar in all 3 groups. The reKT recipients were on dialysis longer before receiving the second KT, with no difference between the other 2 groups. Graft survival of reKT patients was lower than the rest (vs. KT after NKSOT, p = 0.014; vs. first KT p < 0.001). Survival between KT after NKSOT and first KT was slightly worse in those who had received a previous NKSOT, but without significant differences. In multivariate analysis, adjusted for time on waiting list, reKT remained a risk factor at the limit of statistical significance (p = 0.072). There was no difference in patient survival. Conclusion KT after NKSOT has similar graft and patient survival outcomes to recipients of a first KT, and better than in recipients of a second KT.