Long-term renal outcome after lung transplantation is predicted by the 1-month postoperative renal function loss

Transplantation. 2000 Apr 27;69(8):1624-8. doi: 10.1097/00007890-200004270-00017.


Background: Progressive renal function loss is common after lung transplantation. To facilitate the design of renoprotective strategies, identification of early predictors for long-term renal function loss would be useful.

Methods: We prospectively analyzed renal function [glomerular filtration rate (GFR); 125I-iothalamate clearance] in a closely monitored cohort (minimum 24-month follow-up) of 57 patients who received lung transplants between November 1990 and September 1996 in our center. The analyzed end points were the slope of the GFR from 6 months posttransplant onward and the GFR at 24 months after transplantation.

Results: Before transplantation, the GFR was 100 ml/min (median, range 59-163). It decreased to 67 ml/min (29-123) at 6 months, 53 ml/min (17-116) at 24 months, and 51 ml/min (20-87) at 36 months after transplantation. The magnitude of the loss of GFR 1 month post-transplantation was the only factor significantly correlated with absolute GFR at 24 months after transplantation. Pulmonary diagnosis was significantly associated with long-term rate of renal function loss. Median loss of GFR was greatest in patients with cystic fibrosis (-10 ml/min/year, range -14 to -6 ml/min/year), preserved in pulmonary hypertension (-1 ml/min/year, range -6 to +7 ml/min/year), and in between in emphysema (-6 ml/min/year, range -27 to +12 ml/min/year). No other factors could be identified.

Conclusions: In lung transplant recipients, the 1-month postoperative loss of GFR is an early marker for long-term renal prognosis. Pulmonary diagnosis appears to be a relevant predictor as well. These factors may guide further research and the development of preventive strategies.

MeSH terms

  • Adult
  • Cyclosporine / blood
  • Cystic Fibrosis / surgery
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Hypertension, Pulmonary / surgery
  • Kidney / physiopathology*
  • Longitudinal Studies
  • Lung Transplantation*
  • Male
  • Middle Aged
  • Postoperative Period
  • Prognosis
  • Prospective Studies
  • Pulmonary Emphysema / surgery


  • Cyclosporine