Clinical Characteristics and Outcomes of Kidney Transplantation in Patients with Autosomal Dominant Polycystic Kidney Disease

Background: Kidney transplantation (KT) is the best treatment for autosomal dominant polycystic kidney disease (ADPKD). We aimed to investigate clinical characteristics and outcomes of KT in ADPKD patients compared to those in non-ADPKD patients. Methods: We retrospectively analyzed KT recipients in two Korean transplantation centers A propensity score-mactching and Cox regression analysis were used to assess the clinical outcomes of ADPKD compared to non-ADPKD and prognostic factors influencing outcomes in ADPKD. Results: Among a total of 4,452 KT patients, 189 (4.2%) were ADPKD patients. In both groups, living-donor KT were more common than deceased-donor KT. The ADPKD group had a 4.09-fold higher risk of post-transplant diabetes mellitus and a 1.65-fold higher risk of post-transplant infection compared to the non-ADPKD group; however, it had similar risk of rejection, graft failure, and mortality. In the ADPKD group, kidney volume decreased after KT irrespective of kidney volume status, while size of hepatic cyst increased. Either kidney volume or nephrectomy of native kidneys was not associated with risk of infection, graft failure, or mortality in the ADPKD group. Conclusion: ADPKD patients have a higher risk of post-transplant diabetes mellitus and infection than non-ADPKD patients without a significant impact of kidney volume or nephrectomy on post-transplant outcomes.Comparative post-transplant outcomesCumulative incidence of post-transplant complications