Late graft failure after kidney transplantation as the consequence of late versus early events
| Autor: | Robert E Leduc, Fernando G. Cosio, Arthur J. Matas, Bertram L. Kasiske, Sita Gourishankar, Ann M. Fieberg, J. Michael Cecka, John E. Connett, Joseph P. Grande, Roslyn B. Mannon, Lawrence G. Hunsicker, David N. Rush, Robert S. Gaston |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Graft Rejection Male medicine.medical_specialty Time Factors Graft failure 030232 urology & nephrology Urology Delayed Graft Function 030230 surgery 03 medical and health sciences chemistry.chemical_compound Postoperative Complications 0302 clinical medicine Risk Factors Chronic allograft nephropathy Biopsy medicine Humans Immunology and Allergy Pharmacology (medical) Prospective Studies Kidney transplantation Transplantation Creatinine Kidney Proteinuria medicine.diagnostic_test business.industry Graft Survival Middle Aged Prognosis medicine.disease Kidney Transplantation Surgery medicine.anatomical_structure chemistry Kidney Failure Chronic Female medicine.symptom business Follow-Up Studies Cohort study |
| Zdroj: | American Journal of Transplantation. 18:1158-1167 |
| ISSN: | 1600-6135 |
| Popis: | Beyond the first posttransplant year, 3% of kidney transplants fail annually. In a prospective, multicenter cohort study, we tested the relative impact of early versus late events on risk of long-term death-censored graft failure (DCGF). In grafts surviving at least 90 days, early events (acute rejection [AR] and delayed graft function [DGF] before day 90) were recorded; serum creatinine (Cr) at day 90 was defined as baseline. Thereafter, a 25% rise in serum Cr or new-onset proteinuria triggered graft biopsy (index biopsy, IBx), allowing comparison of risk of DCGF associated with early events (AR, DGF, baseline serum Cr >2.0 mg/dL) to that associated with later events (IBx). Among 3678 patients followed for 4.7 ± 1.9 years, 753 (20%) had IBx at a median of 15.3 months posttransplant. Early AR (HR = 1.77, P |
| Databáze: | OpenAIRE |
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