Belal AA, Bourricaudy RA, Saba Z, Alquadan KF, Kazory A, Santos Jr AH. Kidney allograft outcomes in combined kidney with other solid organ transplantation. World J Transplant 2026; 16(1): 114233 [DOI: 10.5500/wjt.v16.i1.114233]
Corresponding Author of This Article
Amer Ashaab Belal, MD, Assistant Professor, FASN, Division of Nephrology, Hypertension, and Renal Transplantation, University of Florida College of Medicine, 1600 Southwest Archer Road, Gainesville, FL 32610, United States. abelal@ufl.edu
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Transplantation
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Mar 18, 2026 (publication date) through Jan 14, 2026
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World Journal of Transplantation
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Belal AA, Bourricaudy RA, Saba Z, Alquadan KF, Kazory A, Santos Jr AH. Kidney allograft outcomes in combined kidney with other solid organ transplantation. World J Transplant 2026; 16(1): 114233 [DOI: 10.5500/wjt.v16.i1.114233]
World J Transplant. Mar 18, 2026; 16(1): 114233 Published online Mar 18, 2026. doi: 10.5500/wjt.v16.i1.114233
Kidney allograft outcomes in combined kidney with other solid organ transplantation
Amer Ashaab Belal, Rafael Aldaya Bourricaudy, Zahra Saba, Kawther F Alquadan, Amir Kazory, Alfonso H Santos Jr
Amer Ashaab Belal, Kawther F Alquadan, Amir Kazory, Alfonso H Santos Jr, Division of Nephrology, Hypertension, and Renal Transplantation, University of Florida College of Medicine, Gainesville, FL 32610, United States
Rafael Aldaya Bourricaudy, Zahra Saba, College of Medicine, University of Florida, Gainesville, FL 32610, United States
Author contributions: Belal AA contributed to leading the original draft; Belal AA, Bourricaud RA and Saba Z contributed to the writing; Belal AA, Bourricaud RA, Saba Z, and Alquadan A contributed to the literature review; Belal AA, Bourricaud RA, Saba Z, and Alquadan A; Kazory A, and Santos Jr AH contributed to the revision the manuscript; Santos Jr AH contributed to the conception. All authors approval of the final version of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Amer Ashaab Belal, MD, Assistant Professor, FASN, Division of Nephrology, Hypertension, and Renal Transplantation, University of Florida College of Medicine, 1600 Southwest Archer Road, Gainesville, FL 32610, United States. abelal@ufl.edu
Received: September 15, 2025 Revised: October 12, 2025 Accepted: December 16, 2025 Published online: March 18, 2026 Processing time: 122 Days and 7 Hours
Abstract
With advances in solid organ transplantation, the option of combined kidney with other solid organ transplantation is an enticing option for patients with advanced kidney disease and concomitant other solid organ failure. Kidney allograft dysfunction is well known to be associated with increased adverse outcomes post solitary kidney transplant however, outcomes for patients and the kidney allograft are somewhat understudied in the setting of kidney transplantation when combined with other solid organ transplantation such as in a simultaneous liver-kidney transplant. We will provide an overview of the current literature available on kidney allograft clinical outcome measures in combined solid organ transplant recipients such as delayed kidney allograft function, kidney allograft rejection, kidney allograft and patient survival metrics and how they compare to patients with kidney transplants alone. Worse kidney allograft survival outcomes were noted in most combined other organ with kidney transplantation (liver-kidney, heart-kidney, and lung-kidney) due to comorbidities attributed to non-renal organ dysfunction whereas improved kidney allograft survival outcomes were noted for pancreas-kidney transplantation.
Core Tip: Combined kidney with other solid organ transplantation has emerged as an enticing option for patients suffering from advanced kidney disease in addition to other advanced non-renal solid organ disease. The increased risk of early kidney allograft failure with most such simultaneous organ transplantation of liver-kidney, heart-kidney, and lung-kidney competes with the overall improved all-cause mortality risk for select patients compared to those receiving their other non-renal organ transplant alone. As recipients of multi-organ transplants often receive priority for quality kidney allografts before waitlisted recipients for a kidney transplant alone, special care must be taken to minimize renal allograft futility.
