The causes and frequency of kidney allograft failure in a low-resource setting: observational data from Iraqi Kurdistan
| Autor: | Safaa E Almukhtar, Kais H Abd, Alaa Abbas Ali, Dana A Sharif, Michael D Hughson, Zana Sidiq M. Saleem |
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| Rok vydání: | 2021 |
| Předmět: |
Nephrology
Adult Graft Rejection Male Kidney allograft pathology Acute and chronic allograft failure medicine.medical_specialty Disease Kidney Allograft rejection Interquartile range Internal medicine Outcome Assessment Health Care Medicine Humans Kidney transplantation Retrospective Studies business.industry Research Graft Survival Transplant glomerulopathy medicine.disease Allografts Kidney Transplantation Diseases of the genitourinary system. Urology Transplantation medicine.anatomical_structure Iraq Kidney Failure Chronic Observational study Female RC870-923 business |
| Zdroj: | BMC Nephrology BMC Nephrology, Vol 22, Iss 1, Pp 1-13 (2021) |
| ISSN: | 1471-2369 |
| Popis: | Background In the developing world, transplantation is the most common long-term treatment for patients with end-stage renal disease, but rates and causes of graft failure are uncertain. Methods This was a retrospective outcomes study of renal transplant patients seen in Iraqi Kurdistan nephrology clinics in the year 2019. In 2019, 871 renal transplant patients were registered and outcomes followed through 12/31/2020. Indicated renal biopsies were obtained on 431 patients at 1 day to 18 years post-transplantation. Outcomes were compared with United States Renal Data System (USRDS) living donor reports. Results All donors were living. The recipient age was 38.5 ± 13.3 years, 98.2% were 75% of these failures taking place in the first year. Most graft failures occurred late, at a median post-transplant time of 1125 (interquartile range, 365–2555) days, and consisted of interstitial fibrosis and tubular atrophy (IF/TA) (23.8%), transplant glomerulopathy (13.7%), and acquired active antibody-mediated rejection (12.0%). The significant predictors of graft loss were C4d + biopsies (P P Conclusions Kurdistan transplant patients had graft failure rates similar to living donors reported by the USRDS for the year 2000 but higher than reported for 2010. Compared to USRDS 2010, Kurdistan patients had a moderate excess of HD failures at one and 5 years post-engraftment. Nevertheless, prolonged survival is the norm, with chronic disorders and acquired DSA being the leading causes of graft loss. |
| Databáze: | OpenAIRE |
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