First 1500 Kidney Transplants at the Institute of Nephrology and Urology in Uruguay: Analysis of the Results
| Autor: | N. Nuñez, Francisco González-Martínez, L. Cuñeti, P. Larre Borges, M. Kurdian, G. González, L. Manzo, L. Curi, Sergio Orihuela, Marcelo Nin |
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| Rok vydání: | 2016 |
| Předmět: |
Nephrology
Adult Male medicine.medical_specialty Adolescent medicine.medical_treatment Urology Population Delayed Graft Function 030230 surgery 03 medical and health sciences Young Adult 0302 clinical medicine Age Distribution Risk Factors Internal medicine medicine Cadaver Humans education Prospective cohort study Child Stroke Kidney transplantation Dialysis Aged Retrospective Studies Transplantation education.field_of_study business.industry Incidence (epidemiology) Incidence Graft Survival Academies and Institutes Retrospective cohort study Middle Aged medicine.disease Kidney Transplantation Tissue Donors Uruguay 030211 gastroenterology & hepatology Surgery Female business |
| Zdroj: | Transplantation proceedings. 48(2) |
| ISSN: | 1873-2623 |
| Popis: | The Institute of Nephrology and Urology (INU) has performed 75% of kidney transplantations (KT) in Uruguay during its 35 years of activity, with 90.6% from cadaveric donors. We investigated the risk factors (RF) for delayed graft function (DGF) and patient and graft survival (SV).We analyzed retrospectively the characteristics and evolution of 1500 KT performed by INU until December 2014. The incidence of DGF and RF for patient and graft SV were analyzed in 4 eras, according to the year that KT was performed.The number of KT per year has progressively increased until reaching 40 KT per million population in 2006, with a decrease of the living donor KT (LDKT) rate. The age of the donors (D) and recipients (R) as well as the time on dialysis (TOD) have progressively increased over the different eras. Five hundred twenty-five R (35%) presented with DGF. The RF for DGF were the age of the R and the D, the TOD, the DDKT, and the warm ischemia time (WIT). In the DDKT group, the cold ischemia time and "died of stroke" were added factors. The death-censored graft SV at 1, 5, 10, and 15 years were 90%, 76%, 62%, and 49%, respectively. They improved as from era I, the patient SV being 92%, 83%, and 75% at 1, 5, and 10 years, in era I; 98%, 93%, and 86% in era II; 98%, 92%, and 83% in era III; and 95% and 90% at 1 and 5 years in era IV (P .001). The graft SV over the same periods was 76%, 58%, and 40% in era I; 88%, 68%, and 52% in era II; 93%, 81%, and 70% in era III; and 93% and 85% at 1 and 5 years in era IV (P .0001). The RF for patient SV were diabetes mellitus, era I, lower albuminemia, older age or TOD, and DGF. For kidney SV, the era, the age of the R, TOD, DGF, and D older than 60 years were RF associated with a worse evolution. In DDKT, the RF for the graft SV were the era, younger age of the R, and DGF. The group with the worst graft SV was the one made up of children and adolescents.Our results relating to patient and graft SV are acceptable and comparable to those mentioned on large records such as the OPNT/SRTR and the Collaborative Transplant Study. This has been the case, even though we have transplanted increasingly aged patients, with increasingly aged donors, or donors with associated pathology. The risk factors that we found both for DGF and SV have also been pointed out by other authors. The validity of some findings has the limitation of being from a retrospective analysis; hence, they should be corroborated by a prospective study. |
| Databáze: | OpenAIRE |
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