Simultaneous Intestinal and Kidney Transplantation in Adults

Amin, Irum; Rutter, Charlotte; Barlow, Adam D.; Russell, Neil; Bradley, J. Andrew; Jackson, Andrew; Butler, Andrew

doi:10.1080/08941939.2017.1409849

Cited by 2 publications

(2 citation statements)

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“…Seven patients have undergone SIKT in Cambridge and early outcomes were comparable to those undergoing IT alone 12 . However, multivariate analysis of factors influencing longer‐term outcomes suggest SIKT is a negative predictor of patient survival 17 …”

Section: Discussionmentioning

confidence: 98%

“…A decline in renal function is also observed in HPN patients and in some, and this is exacerbated by high stoma outputs or fistula losses 9,10 . Patients who develop severe CKD are considered for a simultaneous intestine and kidney transplant (SIKT) 5,11,12 . Current UK guidance advocates SIKT for adult patients established on dialysis or those with a corrected GFR of <45 ml/min/m 2 13 .…”

Section: Introductionmentioning

confidence: 99%

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Decline in renal function following intestinal transplant: is the die cast at 3 months?

Rutter

Russell

Sharkey

et al. 2021

Clinical Transplantation

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Introduction This study reports the incidence of chronic kidney disease (CKD) after intestinal transplant (IT) at a single, adult center in the United Kingdom. Methods A retrospective review of IT was undertaken. Methods of renal function assessment pre‐transplant were compared. Post‐transplant renal function and renal sparing strategies were analyzed. Results There was a 30% variation (p < .001) in estimated glomerular filtration rate (eGFR) and normalized GFR at assessment. In the first 3 months post‐transplant, there was a 40% decline in eGFR which was irreversible. Liver inclusion was not protective with similar eGFR at 3 months (60 ml/min/1.73 m2) compared with IT (55 ml/min/1.73 m2). The rate of decline in the first 2 months was less in multivisceral transplant (MVT; 21%) than IT (52%) suggesting surgical magnitude did not contribute. Thirty percentage of recipients had acute cellular rejection post‐transplant; 58% of these were in the first 3 months with a higher proportion in MVT (64%) than IT (27%). Tacrolimus exposure did not correlate with decline in renal function over the first 3 months post‐transplant. Conclusion We demonstrated a 40% decline in renal function within 3 months post‐IT which was irreversible despite renal sparing strategies. Early intervention should be considered in patients with an acute decline in this post‐transplant period.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%