Thrombotic microangiopathy after renal transplantation in the United States1 1The opinions expressed are solely those of the authors and do not represent an endorsement by the Department of Defense or the National Institutes of Health.This is a US government work. There are no restrictions on its use
| Autor: | Joel C. Reynolds, Christina M. Yuan, Lawrence Y. Agodoa, Kevin C. Abbott |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
medicine.medical_specialty
education.field_of_study Thrombotic microangiopathy business.industry Microangiopathy Population Thrombotic thrombocytopenic purpura urologic and male genital diseases medicine.disease female genital diseases and pregnancy complications Surgery Transplantation Nephrology hemic and lymphatic diseases Internal medicine medicine Risk factor education business neoplasms Kidney transplantation Kidney disease |
| Zdroj: | American Journal of Kidney Diseases. 42:1058-1068 |
| ISSN: | 0272-6386 |
| DOI: | 10.1016/j.ajkd.2003.07.008 |
| Popis: | Background: Analysis of the incidence, time to event, and risk factors for thrombotic microangiopathy (TMA) after renal transplantation (RT), has not been reported in a national population. Methods: This is a historical cohort study of 15,870 RT recipients in the United States Renal Data System (USRDS) with Medicare as their primary payer between January 1, 1998, and July 31, 2000, followed until December 31, 2000. Patients with Medicare claims with a diagnosis of TMA (International Classification of Diseases, 9th Revision, codes 283.11x or 446.6x) after RT were assessed by Cox regression. Results: Among patients with end-stage renal disease owing to hemolytic uremic syndrome (HUS), 29.2% later had TMA versus 0.8% of patients with ESRD owing to other causes. The incidence of TMA in RT recipients was 5.6 episodes per 1,000 person-years (PY; 189/1,000 PY; for recurrent TMA versus 4.9/1,000 PY for de novo TMA). The risk of TMA was highest for the first 3 months after transplant. Risk factors for de novo TMA included younger recipient age, older donor age, female recipient, and initial use of sirolimus. Patient survival rate after TMA was approximately 50% at 3 years. Conclusion: De novo TMA is uncommon and may occur later after RT than previously reported. Risk factors for de novo TMA were also identified. |
| Databáze: | OpenAIRE |
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