Abstract: SA-PO985
Comparative Analysis of Infection and Rejection Rates for Recipients of Kidney-after-Liver (KALT) Compared with Simultaneous Liver and Kidney Transplant (SLK)
Session Information
- Transplantation: Clinical - 3
October 26, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Abu Kar, Sarah, Vanderbilt University Medical Center, Nashville, Tennessee, United States
- Binari, Laura, Vanderbilt University Medical Center, Nashville, Tennessee, United States
- Rega, Scott A., Vanderbilt University Medical Center, Nashville, Tennessee, United States
- Feurer, Irene, Vanderbilt University Medical Center, Nashville, Tennessee, United States
- Shawar, Saed, Vanderbilt University Medical Center, Nashville, Tennessee, United States
Background
We investigated 1- and 3 year kidney allograft and patient outcomes for recipients of (KALT) compared to (SLK). Analysis of infection and rejection outcomes by induction type and panel reactive antibody (PRA) was performed.
Methods
Data were collected from the records for patients who had SLK or KALT at Vanderbilt University Medical Center between 1983 and 2022. Patients with multiple kidney transplants or insufficient data were excluded.
Data were analyzed using summary statistics, chi square, ANOVA, and Kaplan-Meier survival and multivariable logistic regression analysis.
Results
59 patients, 39 KALT and 20 SLK recipients, were included. Age at kidney transplant was 57±10 years. Among all patients, kidney induction therapy was 44% alemtuzumab, 27% basiliximab, 24% methylprednisolone and 5% thymoglobulin. A higher proportion of KALT received alemtuzumab (62% vs 10% SLK), whereas more SLK patients (60% vs 5% KALT) received methylprednisolone ( p<0.05). Maintenance IS did not differ between the two groups. Mean serum creatinine and GFR at 1-year (1.29±0.39 mg/dL, 57.31±19.9 ml/min/1.73m2) and 3-years (1.32±0.37 mg/dL, 54±17.6 ml/min/1.73m2) did not differ between the two groups. Point estimates of 3-year patient and death-censored graft survival were 84.6% (SE= 4.7%) and 93.1% (SE= 3.3%), respectively.
Univariate analyses showed no difference in rate of rejection within 1 and 3 years by induction regimen or between SLK and KALT patients. Among person with at least 33 months follow-up after adjusting for induction regimen, the multivariable analysis may suggest that SLK recipients had increased likelihood of rejection within the first 3 years (p=0.051).
Rates of infection within 1 and 3 years did not differ by induction regimen or between SLK and KALT . Mean PRA for patients who had alemtuzumab induction (44.7±41.6%) was higher than mean PRA for methylprednisolone induction (11.3±24.6 %) (p =0.045). Mean PRA did not differ significantly among patients experiencing at least one infection or one rejection within 1 and 3 years compared to those who did not.
Conclusion
Infection and rejection rates did not differ between SLK and KALT recipients within 1 year after adjusting for different induction therapies. Additionally, PRA levels were not related to infection or rejection rates.