Long-term outcomes after kidney transplant failure and variables related to risk of death and probability of retransplant: Results from a single-center cohort study in Brazil

Autor: Paula Rebello Bicalho, Lúcio R. Requião-Moura, Cássio R. Moreira Albino, Alvaro Pacheco-Silva, Érika de Arruda Ferraz, Luciana Mello de Mello Barros Pires, Maurício Fregonesi Rodrigues da Silva
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Graft Rejection
Male
Physiology
Epidemiology
medicine.medical_treatment
030232 urology & nephrology
030230 surgery
Nephrectomy
Endocrinology
Medical Conditions
0302 clinical medicine
Risk Factors
Chronic Kidney Disease
Medicine and Health Sciences
Renal Transplantation
Living Donors
Risk of mortality
Multidisciplinary
Mortality rate
Hazard ratio
Middle Aged
Body Fluids
Blood
Nephrology
Medicine
Female
Anatomy
Brazil
Research Article
Cohort study
Adult
medicine.medical_specialty
Endocrine Disorders
Science
Surgical and Invasive Medical Procedures
Lower risk
Urinary System Procedures
ABO Blood-Group System
03 medical and health sciences
Internal medicine
Medical Dialysis
Renal Diseases
Diabetes Mellitus
medicine
Humans
Dialysis
Retrospective Studies
Transplantation
Surgical Excision
Proportional hazards model
business.industry
Biology and Life Sciences
Kidneys
Organ Transplantation
Renal System
Kidney Transplantation
Metabolic Disorders
Medical Risk Factors
business
Follow-Up Studies
Zdroj: PLoS ONE, Vol 16, Iss 1, p e0245628 (2021)
PLoS ONE
ISSN: 1932-6203
Popis: BackgroundReturning to dialysis after kidney graft loss (GL) is associated with a high risk of mortality, mainly in the first 3–6 months. The follow-up of patients with GL should be extended to better understand crude patient outcomes, mainly in emerging countries, where the transplantation activity has increased.MethodsThis is a historical single-center cohort study conducted in an emerging country (Brazil) that included 115 transplant patients with kidney allograft failure who were followed for 44.1 (21.4; 72.6) months after GL. The outcomes were death or retransplantation after GL calculated by Kaplan-Meier and log-rank tests. Proportional hazard ratios for death and retransplantation were assessed by Cox regression.ResultsThe 5-year probability of retransplantation was 38.7% (95% CI: 26.1%-51.2%) and that of death was 37.7% (95% CI: 24.9%-50.5%); OR = 1.03 (95% CI: 0.71–1.70) and P = 0.66. The likelihood of retransplantation was higher in patients who resumed dialysis with higher levels of hemoglobin (HR = 1.22; 95% CI = 1.04–1.43; P = 0.01) and lower in blood type O patients (HR = 0.48; 95% CI = 0.25–0.93; P = 0.03), which was associated with a lower frequency of retransplantation with a subsequent living-donor kidney. On the other hand, the risk of death was significantly associated with Charlson comorbidity index (HR for each point = 1.37; 95% CI 1.19–1.50; PConclusionsThe 5-year probability of retransplantation was not less than that of death. Variables related to the probability of retransplantation were hemoglobin level before resuming dialysis and ABO blood type, while the risk of death was associated with comorbidities and residual eGFR.
Databáze: OpenAIRE
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