Serial T Cell Chimerism predicts GVHD in Intestinal Transplant (ITx) Recepients

immunosuppression, and serial creatinine levels.The cumulative incidence of dialysis was estimated using a Fine-Gray model with death as a competing risk.Results: Of 136 ITx, 25 (18%) had liver-inclusive grafts, and 9 (7%) received colon.Median pre-transplant serum creatinine was 0.79 mg/dL (IQR, 0.65-0.95).Within six months, three patients died with shock-related acute kidney failure.Chronic kidney failure developed in 11 patients, with dialysis initiated at a median of 4.3 years post-transplant; five later underwent kidney transplantation.Serum creatinine at two months was the sole significant predictor of dialysis ], p<0.001).Sub-distribution hazard ratio plots determined a creatinine threshold of 1.2 mg/dL at two months (A).Overall, cumulative incidences of chronic kidney failure were 3%, 16%, and 23% at three, five, and ten years, respectively, and increased significantly among those with creatinine 1.2 mg/dL at two months (HR 5.69,], p=0.003,B).Conclusions: ITx recipients face a notable risk of chronic kidney failure.Creatinine elevation as early as two months strongly predicts progression to dialysis, underscoring the importance of aggressive strategies to mitigate further renal injury in this high-risk population.