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Kidney 1

Sunday March 26, 2023 - 10:00 to 11:00

Room: Zilker 3-4

205.6 Kidney graft outcomes following kidney versus simultaneous liver-kidney transplantation – an UNOS database analysis

Award Winner

Pankaj Chandak, United Kingdom has been granted the IPTA Scientific Congress Award

Pankaj Chandak, United Kingdom

Transplant Surgical Trainee and Post Doctoral Research Fellow
Transplantation, Immunology and Faculty of Life Sciences
King's College London and Institute of Child Health UCL

Biography


Pankaj Chandak Transplant Surgery and Post-doctoral Research Fellow London Deanery, King’s College London and Institute of Child Health, UCL Pankaj is a transplant surgery fellow and post-doctoral research fellow at King's College London and Institute of Child Health, Great Ormond Street Hospitals and London Deanery hospitals having completed his PhD in overcoming immunological and surgical barriers in complex transplantation. His scientific interests are in machine perfusion of human organs for therapeutic manipulation, regeneration and repair and complex paediatric transplantation. He is also active in public engagement in science. His research led to the first use of 3D printing for complex paediatric transplantation and the first translational human model of antibody mediated rejection using normothermic machine perfusion. He has been invited speaker to several societies including The Royal Society (London) and The Royal Institution and has received several awards including The British Science Association Charles Darwin Award Lecture, The Royal College of Surgeons of England Lister Medal and Prize and The Royal College of Surgeons Arnott Lecture and Medal. He has made appearances for BBC and film and BBC World Service Radio and set up the UK's first Children's Transplant Choir with BBC Children in Need. He is also medical director and advisor to the Netflix Series The Crown and has acted in several episodes. In 2023, he was awarded the prestigious Hunterian Professorship by The Royal College of Surgeons of England as well as the King's Health Partner's Bulkley Barry Cooper Professorship Lecture. He was elected a Fellow of The Linnean Society and a Fellow of the Royal Photographic Society (FRPS) in 2023, having been awarded the RPS Combined Royal Colleges Medal for advances in imaging sciences.

Abstract

Kidney graft outcomes following kidney versus simultaneous liver-kidney transplantation – an UNOS database analysis

pankaj chandak1, Ioannis D. Kostakis1, Mikaela M. Charalambides1, Petrut Gogalniceanu1, George Papadakis1, Jelena Stojanovic, 2, Francis Calder1, Ioannis Loukopoulos1, Nicos Kessaris1.

1Paediatric Transplantation, Guy's, Evelina and Great Ormond Street Hospitals, London UK, London, United Kingdom; 2Paediatric Transplantation, Great Ormond Street Hospital , London, United Kingdom

Introduction: Simultaneous liver-kidney transplantation may confer an immunological advantage to the kidney graft. The aim of this study is to explore kidney graft outcomes following kidney versus simultaneous liver-kidney transplantation following the analysis of a large database.
Methods: Data were retrieved and analysed on kidney and combined liver-kidney transplants performed in pediatric recipients (younger than 18 years old) from October 1987 until September 2020, from the United Network for Organ Sharing (https://unos.org/). SPSS v28 was used for statistical analysis.
Results: There were 23597 kidney transplants (Group 1, 9628 female, median age 12, IQR 8) and 373 simultaneous liver-kidney transplants (Group 2, 183 female, median age 9, IQR 9). 10785 (45.7%) kidney grafts failed versus 109 (29.2%) kidneys from the simultaneous liver-kidney transplant group (P<0.001). Delayed graft function was present in 2068 (8.8%) in Group 1 and 70 (19%) in Group 2 (P<0.001). Primary non-function was 248 (1.1%) in Group 1 versus 7 (1.9%) in Group 2 (P=0.198). Kaplan-Meier Survival analysis showed a statistically significant difference between the two Groups (Log Rank of <0.001).

Conclusion: Delayed graft function is longer following simultaneous liver-kidney transplants. Despite this, simultaneous liver-kidney transplants have a better survival than kidney transplants alone. This may be due to the protective immunological effect of the liver transplant.

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