Risk factors for graft loss and mortality after renal transplantation according to recipient age: a prospective multicentre study
نویسندگان
چکیده
BACKGROUND To describe the causes of graft loss, patient death and survival figures in kidney transplant patients in Spain based on the recipient's age. METHODS The results at 5 years of post-transplant cardiovascular disease (CVD) patients, taken from a database on CVD, were prospectively analysed, i.e. a total of 2600 transplanted patients during 2000-2002 in 14 Spanish renal transplant units, most of them receiving their organ from cadaver donors. Patients were grouped according to the recipient's age: Group A: <40 years, Group B: 40-60 years and Group C: >60 years. The most frequent immunosuppressive regimen included tacrolimus, mycophenolate mofetil and steroids. RESULTS Patients were distributed as follows: 25.85% in Group A (>40 years), 50.9% in Group B (40-60 years) and 23.19% in Group C (>60). The 5-year survival for the different age groups was 97.4, 90.8 and 77.7%, respectively. Death-censored graft survival was 88, 84.2 and 79.1%, respectively, and non death-censored graft survival was 82.1, 80.3 and 64.7%, respectively. Across all age groups, CVD and infections were the most frequent cause of death. The main causes of graft loss were chronic allograft dysfunction in patients <40 years old and death with functioning graft in the two remaining groups. In the multivariate analysis for graft survival, only elevated creatinine levels and proteinuria >1 g at 6 months post-transplantation were statistically significant in the three age groups. The patient survival multivariate analysis did not achieve a statistically significant common factor in the three age groups. CONCLUSIONS Five-year results show an excellent recipient survival and graft survival, especially in the youngest age group. Death with functioning graft is the leading cause of graft loss in patients >40 years. Early improvement of renal function and proteinuria together with strict control of cardiovascular risk factors are mandatory.
منابع مشابه
گزارش 7 مورد نتایج پیوند کلیه در کلیه های چند شریانه با بیش از یک آناستوموز بین شریانهای دهنده و گیرنده در بیمارستان هاشمی نژاد تهران (گزارش کوتاه)
Background and purpose:We evaluated outcome of transplantation in donors MRAs that underwent multiple anastomosis in recipient, according to graft function, survey of graft and recipient, hypertension before and after transplantation, and surgical complications, comparable with single renal artery and MRA that was converted to a single artery before transplantation. Materials and methods:In ...
متن کاملUniversity of Groningen Renal function after solid organ transplantation
Chronic progressive renal function loss is a main cause of long-term graft loss after initially successful renal transplantation. Transplanted kidneys share some risk factors for renal function loss, such as hypertension or proteinuria, with diseased native kidneys. Recently, it has been shown that renal function loss is influenced by the angiotensin-converting enzyme (ACE)(insertion/detection ...
متن کاملPositive pretransplantation cytomegalovirus serology is a risk factor for cardiac allograft vasculopathy in children.
BACKGROUND Cytomegalovirus (CMV) infection has been implicated as a cause of posttransplantation coronary artery disease in adults. The purpose of this retrospective observational study was to evaluate the effect of CMV on outcome after heart transplantation in children. METHODS AND RESULTS Risk factors tested were recipient age, sex, and pretransplantation CMV serology; use of anti-CMV proph...
متن کاملThe impact of donor age on the results of renal transplantation.
BACKGROUND The use of elderly donors is becoming more frequent. An increase in the donor's age is associated with a greater incidence of delayed graft function (DGF), chronic allograft nephropathy (CAN) and worse graft survival. Poor renal graft function is a risk factor for cardiovascular (CV) complications and, finally, for mortality of the patients. METHODS A total of 3365 adult patients t...
متن کاملبررسی فراوانی و عوامل خطر کلیه پیوندی با عملکرد کند در پیوند کلیه از دهنده زنده
Background: While excellent organ quality and ideal transplant conditions eliminate many of the known factors that compromise initial graft function (IGF), slow graft function (SGF), still occurs after living donor kidney transplantation (LDKT). The aim of our current study is determination SGF frequency and its risk factors in LDKT Methods: In this prospective study, between April 2004 and Mar...
متن کامل