title: Renal transplantation following previous heart, liver, and lung transplantation: an 8-year single-center experience.
abstract: BACKGROUND
  Long-term follow-up of heart, liver, and lung transplantation has led to an increased recognition of secondary end-stage renal failure (ESRF) in transplant recipients. This study examines our center's experience with renal transplantation following previous solid organ transplantation.
  
  
  METHODS
  From January 1, 1992, to September 30, 1999, our center performed 18 renal transplants in previous solid organ recipients. During the same period, 815 total renal transplants were performed. One- and 3-year graft and patient survival, recipient demographics, donor type, and reason for transplantation were compared between these groups.
  
  
  RESULTS
  Of the 18 recipients, 7 had prior heart transplants, 4 had prior liver transplants, and 7 had prior lung transplants. Cyclosporine toxicity contributed to renal failure in 17 (94.4%) of the patients-either as a sole factor (11 patients) or in combination with hypertension, renal artery stenosis, or tacrolimus toxicity (6 patients). Kaplan-Meier 1- and 3-year patient survival was 82.9% and 73.7%, compared with 95.5% and 90.7% in all renal transplant recipients. No surviving patient has suffered renal allograft loss. Mean current creatinine level is 1.4 mg/dL.
  
  
  CONCLUSIONS
  Renal transplantation is an excellent therapy for ESRF following prior solid organ transplantation. One and 3-year patient and graft survival demonstrate the utility of renal transplantation in this patient population.
authors.affiliation: Washington University School of Medicine, St Louis, MO, USA.
authors.forename: C M
authors.initials: CM
authors.lastname: Coopersmith
authors.forename: D C
authors.initials: DC
authors.lastname: Brennan
authors.forename: B
authors.initials: B
authors.lastname: Miller
authors.forename: C
authors.initials: C
authors.lastname: Wang
authors.forename: P
authors.initials: P
authors.lastname: Hmiel
authors.forename: S
authors.initials: S
authors.lastname: Shenoy
authors.forename: V
authors.initials: V
authors.lastname: Ramachandran
authors.forename: M D
authors.initials: MD
authors.lastname: Jendrisak
authors.forename: C S
authors.initials: CS
authors.lastname: Ceriotti
authors.forename: T
authors.initials: T
authors.lastname: Mohanakumar
authors.forename: J A
authors.initials: JA
authors.lastname: Lowell
mesh_terms: D005500:Follow-Up Studies; D006085:Graft Survival; D016027:Heart Transplantation; D006801:Humans; D007165:Immunosuppression Therapy; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation; D016031:Liver Transplantation; D016040:Lung Transplantation; D012086:Reoperation; D016019:Survival Analysis