Graft intolerance syndrome requiring graft nephrectomy after late kidney graft failure: can it be predicted? A retrospective cohort study

Autor: Carmen Verhoeks, Jan A.J.G. van den Brand, Luuk B. Hilbrands, Kim L W Bunthof
Rok vydání: 2018
Předmět:
Adult
Graft Rejection
Male
Reoperation
medicine.medical_specialty
Graft failure
Time Factors
medicine.medical_treatment
030232 urology & nephrology
030230 surgery
Competing risks
Nephrectomy
Risk Assessment
Statistics
Nonparametric
Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18]
Cohort Studies
03 medical and health sciences
0302 clinical medicine
All institutes and research themes of the Radboud University Medical Center
Predictive Value of Tests
medicine
Humans
Retrospective Studies
Transplantation
Kidney
Chi-Square Distribution
business.industry
Retrospective cohort study
Syndrome
Middle Aged
Kidney Transplantation
Surgery
surgical procedures
operative
medicine.anatomical_structure
Treatment Outcome
Current practice
Multivariate prediction
Kidney Failure
Chronic
Female
Renal disorders Radboud Institute for Health Sciences [Radboudumc 11]
business
Follow-Up Studies
Zdroj: Transplant International, 31, 220-229
Transplant International, 31, 2, pp. 220-229
ISSN: 0934-0874
Popis: Background Graft nephrectomy is recommended in case of early graft failure. When the graft fails more than 3-6 months after transplantation it is current practice to follow a wait-and-see policy. A common indication for graft removal is the graft intolerance syndrome. We aimed to create a risk prediction model for the occurrence of graft intolerance resulting in graft nephrectomy. Methods We collected data of kidney transplantations performed in our centre between 1980 and 2010 that failed at least 6 months after transplantation. We evaluated the association between baseline characteristics and the occurrence of graft nephrectomy because of graft intolerance using a competing risk regression model. Prognostic factors were included in a multivariate prediction model. Results In and -exclusion criteria were met in 288 cases. In 48 patients the graft was removed because of graft intolerance. Donor age, the number of rejections and shorter graft survival were predictive factors forgraft nephrectomy because of the graft intolerance syndrome. These factors were included in a prediction rule. Conclusion Using donor age, graft survival, and the number of rejections, clinicians can predict the need for graft nephrectomy with a reasonable accuracy. This article is protected by copyright. All rights reserved.
Databáze: OpenAIRE
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