2011 - ISBTS 2011 Symposium


Oral Communications 7: Complications

9.153 - Factor influencing kidney function on adults after intestinal transplant: report from a single institution

Presenter: Augusto, Lauro, Bologna, Italy
Authors: Augusto Lauro1, Chiara Zanfi1, Sara Pellegrini1, Fausto Catena1, Loris Pironi1, Antonio Pinna1


153
Factor influencing kidney function on adults after intestinal transplant: report from a single institution

Augusto Lauro, Chiara Zanfi, Sara Pellegrini, Fausto Catena, Loris Pironi, Antonio Pinna

S. Orsola Hospital - Liver and Multiorgan Transplant Center, Bologna, Italy

Aim: Kidney function usually deteriorates after intestinal transplant, with prevalence of renal failure  almost 20% after 5 years. We report our results on adults from single institution over more than 10 years.

Subjects and methods: Forty-six patients were transplanted  with 22 survivors; we divided them in two groups: Group 1 represented by recipients with creatinine value above 1.2 (N.V.= 0.50-1.2 mg/dL) while Group 2 has normal creatinine.

Results: Group 1 is represented by 12 patients, 9 males, mean age 42.8 years, all at home, with normal creatinine at transplant  (apart from one :creatinine 1.6), mainly transplanted for short bowel syndrome. One underwent  re-transplant. Immunosuppression was based mainly on Alemtuzumab (8 recipients) plus FK (all patients).Added or replaced immunosuppression was performed on 5 recipients (one is out of FK, on azathioprine, steroids and rapamicine). All received antifungal and antiviral therapy.Regarding kidney function, 2 patients  have A-V fistulabut only 1 on dialysis.  Two recipients require TPN  and 3 have the stoma still open. Group 2 is represented by 10 patients, 6 males, mean age 34.7 years, all at home, with normal creatinine at transplant, mainly transplanted for short bowel syndrome. Immunosuppression was mainly based on Alemtuzumab (8 recipients) plus FK (all patients).Added or replaced immunosuppression was performed on 5 recipients (one is out of FK, on rapamicine). All received antifungal and antiviral therapy. Regarding kidney function, all patients do not need renal replacement therapy. One patient is on TPN and two have the stoma still open.

Conclusions: There were no relevant differences- between two groups- regarding number of recipients, sex, baseline creatinine at transplant, causes of transplant, re-transplantation, immunosuppression, antifungal or antiviral therapy, hospitalization, TPN (or fluids), stoma. Relevant difference is the age, older for patients with deteriorated kidney function or altered creatinine 


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