Abstract: FR-PO878
Outcome of Kidney Transplantation in Recipients With Intellectual Disability
Session Information
- Diversity and Equity in Kidney Health - II
November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Diversity and Equity in Kidney Health
- 800 Diversity and Equity in Kidney Health
Authors
- Phan, Tramanh, University of Rochester, Rochester, New York, United States
- Alom, Md Saiful, University of Rochester, Rochester, New York, United States
- Mcgahan, Stacey, University of Rochester, Rochester, New York, United States
- Taylor, Jeremy G., University of Rochester, Rochester, New York, United States
- Liebman, Scott E., University of Rochester, Rochester, New York, United States
Background
Kidney transplantation offers significant mortality and quality of life benefits compared to dialysis. Every eligible end-stage renal disease patient (ESRD) should be evaluated for a transplant. Historically, ESRD patients with intellectual disability (ID) are at a disadvantage during the transplant evaluation process due to concerns related to their understanding of the process and medical compliance. There is a paucity of data evaluating the outcome of kidney transplantation in this group of people.
Methods
Our retrospective study investigated the clinical outcomes of kidney transplantation in recipients with ID at the University of Rochester Medical Center (URMC). Subjects were identified using ICD10 codes utilized by the division of Behavioral Pediatrics in identifying intellectual disability. We identified 23 individuals who received 25 allografts between January 1991 and December 2019. Fifteen individuals receive services from Office for People with Developmental Disabilities.
Results
The one-year and three-year graft survival rates of ID recipients were 100%. This compares favorably to our institutional outcomes. URMC’s one-year graft survival rate is 95.4%; the rate from living donors is 100%, and from deceased donors is 92%. Our three-year graft survival rate is 92.9%; the rate from living donors is 94.5%, and from deceased donors is 91.5%. The mean follow-up time was 12.6 ± 7.2 years. The mean post-transplant vintage was 11.7 ± 7.5 years. There were 4 allograft failures from 3 recipients. Allograft vintage at the time of failure from two of the subjects was 22.5 years and 17.5 years. In the subject with two episodes of allograft failure, the vintage of the allografts was 5.6 years and 4.7 years. There were 9 rejection episodes; only 2 of these led to graft loss and both occurred in the same subject. Of the subjects with functional grafts, the average creatinine was 1.3 ± 0.47 mg/dl.
Conclusion
We believe that ID should not be factored into the kidney transplant evaluation process. If individuals with ID have a good support system, they appear to benefit from transplantation similar to those without ID.