Kidney transplantation in Romania: two transplant centers experience
| Autor: | C Gîngu, Ioanel Sinescu, Dorina Tacu, Dimitrie Siriopol, Cristina Bucsa, Andra Nastasa, Adrian Covic, A Miron, Angelica Gramaticu |
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| Rok vydání: | 2017 |
| Předmět: |
Nephrology
Adult Graft Rejection Male medicine.medical_specialty Urology medicine.medical_treatment 030232 urology & nephrology 030230 surgery 03 medical and health sciences 0302 clinical medicine Renal Dialysis Internal medicine medicine Humans Survival rate Dialysis Survival analysis Kidney transplantation Retrospective Studies Proportional hazards model business.industry Romania Graft Survival Retrospective cohort study Middle Aged medicine.disease Kidney Transplantation Transplantation Survival Rate Outcome and Process Assessment Health Care Kidney Failure Chronic Female business Glomerular Filtration Rate |
| Zdroj: | International urology and nephrology. 50(2) |
| ISSN: | 1573-2584 |
| Popis: | Kidney graft survival rates improved from decade to decade, but data about factors that affect patient and graft survival remain challenging and even controversial. We analyzed retrospectively data from kidney transplanted patients followed in two Romanian transplant centers (Iasi and Bucharest)—new programmes specifically developed after 1989 to cover transplantation requirements for two-thirds of Romania. We used a composite survival outcome defined as 50% reduction in estimated glomerular filtration rate (eGFR), return to dialysis or death. Survival analysis was performed using uni- and multivariable Cox regression with baseline and time-updated covariates. From the entire cohort of 365 patients, 243 had the outcome of interest. In the univariable Cox survival analysis, age, hemoglobin, eGFR, cholesterol, AST and transplant center were associated with the outcome. The multivariable Cox analysis reveals that only cholesterol (HR 0.97, 95% CI 0.94–0.99 per 10 mg/dL increase) and transplant center (HR 3.64, 95% CI 2.67–4.97) remain associated. For the time-updated Cox survival analysis we found that eGFR (HR 0.91, 95% CI 0.87–0.96 per 10 ml/min/1.73 m2 increase) and cholesterol are associated with the outcome in the univariable analysis and only eGFR and transplant center in the multivariable Cox survival analysis. Our study reports data from two distinct transplant centers from a developing country. Our results are similar to the current literature data, but also reveal that the approach of a center to the transplantation management is an independent factor associated with graft survival. |
| Databáze: | OpenAIRE |
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