title: Risk stratification for renal transplantation after cardiac or lung transplantation: single-center experience and review of the literature.
abstract: BACKGROUND
  Long-term survival after heart (HTx) or lung (LuTx) transplantation increases the risk for end-stage renal disease (ESRD). After HTx ESRD was reported to enhance mortality, and kidney transplantation (KTx) was shown to improve survival. However, prognostic factors in ESRD after HTx or LuTx are largely unknown.
  
  
  METHODS
  Single-center observational study in HTx and LuTx patients who accessed the KTx waiting list; baseline characteristics were correlated with mortality.
  
  
  RESULTS
  KTx was performed in 15 of 65 study patients. Survival was comparable on the KTx waiting list and in reference patients from the same center without ESRD. KTx significantly improved survival (5 years' survival 84.6% with KTx vs. 56.5% on the KTx waiting list, p = 0.030). None of the baseline parameters predicted mortality in the KTx group. Only on the KTx waiting list BMI (median 24.7 vs. 20.7; p < 0.05) and left ventricular ejection fraction (LVEF, median 63 vs. 53%, p < 0.008) significantly correlated with survival.
  
  
  CONCLUSIONS
  The risk for mortality after HTx or LuTx is not increased by ESRD, provided that patients meet access criteria for the KTx waiting list. KTx improves survival in ESRD after HTx or LuTx. BMI and LVEF may predict outcome in HTx/LuTx patients on the KTx waiting list.
authors.affiliation: Nephrology and Medical Intensive Care, Charité Universitätsmedizin, Berlin, Germany. chrosenbe@aol.com <chrosenbe@aol.com>
authors.forename: Christian
authors.initials: C
authors.lastname: Rosenberger
authors.forename: Julia
authors.initials: J
authors.lastname: Stein
authors.forename: Jan Steffen
authors.initials: JS
authors.lastname: Jürgensen
authors.forename: Nermin
authors.initials: N
authors.lastname: Eibl
authors.forename: Nina
authors.initials: N
authors.lastname: Babel
authors.forename: Ulrike
authors.initials: U
authors.lastname: Bachmann
authors.forename: Dagmar
authors.initials: D
authors.lastname: Kemper
authors.forename: Christoph
authors.initials: C
authors.lastname: Knosalla
authors.forename: Roland
authors.initials: R
authors.lastname: Hetzer
authors.forename: Ulrich
authors.initials: U
authors.lastname: Frei
authors.forename: Hans
authors.initials: H
authors.lastname: Lehmkuhl
authors.forename: Petra
authors.initials: P
authors.lastname: Reinke
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D016027:Heart Transplantation / Q000009:adverse effects* / Q000401:mortality* / Q000639:trends; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000401:mortality* / Q000639:trends; D016040:Lung Transplantation / Q000009:adverse effects* / Q000401:mortality* / Q000639:trends; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors