Nonimmunologic Factors Affecting Long-Term Outcomes of Deceased-Donor Kidney Transplant
| Autor: | Abdullah Al Sayyari, Mona Ahmed Al Alshehri, Batool Mousa Alaskar, Ghada Mahaya Almutairi, Shahad Farhan Alenazi, Maha Ahmed Sheikho |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Graft Rejection Male medicine.medical_specialty Time Factors Saudi Arabia Gastroenterology Risk Assessment Donor Selection chemistry.chemical_compound Risk Factors Internal medicine Diabetes mellitus Cause of Death Biopsy medicine Humans Cause of death Retrospective Studies Transplantation Creatinine medicine.diagnostic_test business.industry Donor selection Graft Survival Acute kidney injury Age Factors Retrospective cohort study Acute Kidney Injury Middle Aged medicine.disease Kidney Transplantation Tissue Donors Blood pressure Treatment Outcome chemistry Female business Immunosuppressive Agents |
| Zdroj: | Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation. 17(6) |
| ISSN: | 2146-8427 |
| Popis: | Objectives We investigated the impact of nonimmuno-logic factors on patient and graft survival after deceased-donor kidney transplant. Materials and methods All deceased-donor kidney transplants performed between January 2004 and December 2015 were included in our analyses. We used the independent t test to calculate significant differences between means above and below medians of various parameters. Results All study patients (N = 205; 58.7% males) received antithymocyte globulin as induction therapy and standard maintenance therapy. Patients were free from infection, malignancy, and cardiac, liver, and pulmonary system abnormalities. Most patients (89.2%) were recipients of a first graft. Median patient age, weight, and cold ischemia time were 38 years, 65 kg, and 15 hours, respectively. Delayed graft function, diabetes mellitus, and hypertension occurred in 19.1%, 43.4%, and 77.9% of patients, respectively. The 1- and 5-year graft survival rates were 95% and 73.8%. Graft survival was not affected by donor or recipient sex or recipient diabetes or hypertension. However, graft survival was longer in patients who received no graft biopsy (8.2 vs 6.9 y; P = .027) and in those who had diagnosis of calcineurin inhibitor nephrotoxicity versus antibody-mediated rejection after biopsy (8.19 vs 3.66 y; P = .0047). Longer survival was shown with donors who had traumatic death versus cerebro-vascular accident (5.9 vs 5.3 y; P = .029) and donors below the 50th percentile in age (8.23 and 7.14 y; P = .0026) but less with donors who had terminal acute kidney injury (6.97 vs 8.16 y; P = .0062). We found a negative correlation between graft survival and donor age (P = .01) and 1-year serum creatinine (P = .01). Conclusions Donor age, cause of brain death, and acute kidney injury affected graft survival in our study cohort but not donor or recipient sex or posttransplant or donor blood pressure. |
| Databáze: | OpenAIRE |
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