Abstract: SA-PO1220
Renal Disease After Lung Transplantation (REDIALT): Kidney Function Decline in a Large European Cohort
Session Information
- Transplantation: Clinical - Complications, Pediatrics, and Multi-Organ Considerations
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2002 Transplantation: Clinical
Authors
- della Volpe, Luca, Universita degli Studi di Milano, Milan, Lombardy, Italy
- Sellares, Joana, Hospital Universitari Vall d'Hebron, Barcelona, CT, Spain
- Meneghini, Maria, Hospital Universitari Vall d'Hebron, Barcelona, CT, Spain
- Alfieri, Carlo, Universita degli Studi di Milano, Milan, Lombardy, Italy
- Castellano, Giuseppe, Universita degli Studi di Milano, Milan, Lombardy, Italy
- Bestard, Oriol, Hospital Universitari Vall d'Hebron, Barcelona, CT, Spain
Background
Chronic kidney disease (CKD) is one of the most frequent complications after lung transplantation (TX) and it is also a main cause of death. Even today the real temporal evolution of kidney impairments after lung TX is still not clear. Our aim was to evaluate the load and the evolution of CKD in a large cohort of patients receiving lung TX at the University Hospital Vall d’Hebron in Barcelona, leading European center for organ transplantation.
Methods
We performed a retrospective observational study among adult patients undergoing lung TX between 2014 and 2024. From the starting 945 patients of this 11 year period, 681 met the inclusion criteria. The renal function was evaluated through creatinine and eGFR, with periodic measurements for a period up to 5 years post-TX. CKD was defined based on KIDGO guidelines, AKI was also defined according tfo KDIGO criteria, focused on patients with at least one episode after transplantation.
Results
The average age of patients was 55.2 ± 10.6 years, a baseline eGFR of 90.9 ± 11.4 mL/min/1.73 m 2. For the follow-up period, CKD occurred in 437 of 681 recipients (64.2%), and 39 patients (5.7%) needed renal replacement therapy. The decline in renal function was observed during the first year after TX, with the mean eGFR dropping from 90.9 at baseline to 76.8 at 3 months, 71.6 at 6 months, and 66.4 mL/min/1.73 m 2 at 1 year, followed by a slower decline thereafter (Figure A). At least one episode of AKI was reported in 386 TX recipients (56.7%), and this was linked to a higher rate of CKD compared to the group without AKI (73.4% vs 53.6%; OR 2.40, 95% CI 1.73–3.31; p<0.001) (Figure B).
Conclusion
In this cohort, the decline in kidney function emerged predominantly during the first year after TX, with CKD involving allmost two-thirds of the recipients. In particular patients with AKI episodes were with an higher renal risk. These results support the importance of monitoring kidney health and implementing nephro-protective strategies after lung TX.