Official websites use. Share sensitive information only on official, secure websites. Corresponding Author: Benoit Mesnard, e-mail: benoit. End-stage renal disease is a major issue in the management of patients undergoing lung transplantation. We conducted a retrospective single-center cohort study. Retrospective extraction of data from medical records was performed. Most of the patients had cystic fibrosis and presented renal failure related to anti-calcineurin toxicity.
The day and 1-year survival of CKLT recipients were both No patients with KALT died during the follow-up. Kidney graft prognosis was almost exclusively influenced by patient survival in relation to postoperative lung transplant complications.
The kidney graft function estimated kidney graft function did not differ according to the transplantation strategy. KALT is a safe option, with postoperative morbidity and renal graft function identical to those of kidney transplantation in non-lung-transplanted patients. The results of CKLT depend mainly on the morbidity associated with lung transplantation but remain an attractive option for patients with respiratory failure associated with end-stage renal disease.
The choice of transplant strategy must also take into account the most ethical and efficient allocation of kidney grafts. First, their renal function is often overestimated by the routine use of serum creatinine to calculate their glomerular filtration rate GFR because creatinine is a muscle waste product; for example, patients affected by cystic fibrosis tend to have severe sarcopenia.
Second, their GFR may be altered because of comorbidities affecting renal vessels such as diabetes mellitus or chronic hypertension [ 3 ]. Last, the sequence of LT begins with major thoracic surgery, which is a known risk factor for acute kidney injury AKI , and AKI is a known risk factor for CKD, and continues with constant exposure to calcineurin inhibitors, the chronic toxicity of which is damages the kidneys, inducing arteriolar hyalinosis and interstitial fibrosis [ 1 , 4 β 7 ].
