Highlight
– The 2023 US safety net policy has altered practices for kidney after lung transplantation, decreasing simultaneous lung-kidney transplants (SLKT) and increasing early kidney after lung transplant (KALT) procedures.
– Early KALT is associated with shorter kidney transplant wait times and better 1-year post-transplant survival compared to SLKT.
– The safety net policy era shows reduced risk of delisting from the kidney transplant waitlist due to deterioration or death.
– Survivorship bias may influence outcomes; prospective studies are necessary to clarify long-term effects.
