Factors associated with patient and graft survival using kidneys from cadaveric donors in transplanted patients over 18 years of age in Argentina

Background: With improvements in short-term kidney graft and patient survival, focus has shifted to understand patient and graft features that affect long-term survival. Materials and methods: This retrospective analysis from January 1998 to December 2009 employed Kaplan-Meier analysis to evaluate s...

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Detalles Bibliográficos
Publicado: 2012
Materias:
antigen
adolescent
adult
anoxia
Argentina
cadaver kidney
cause of death
child
chronic kidney failure
coma
conference paper
controlled study
data analysis software
dialysis
female
graft survival
head injury
HLA system
human
kidney transplantation
male
mismatch negativity
priority journal
proportional hazards model
school child
sex difference
stroke
survival rate
survival time
tumor
Acceso en línea:https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_00411345_v44_n7_p2235_Bisigniano
http://hdl.handle.net/20.500.12110/paper_00411345_v44_n7_p2235_Bisigniano
Aporte de:
Biblioteca Digital - Facultad de Ciencias Exactas y Naturales (UBA) de Universidad de Buenos Aires
id paper:paper_00411345_v44_n7_p2235_Bisigniano
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spelling paper:paper_00411345_v44_n7_p2235_Bisigniano2023-06-08T15:04:46Z Factors associated with patient and graft survival using kidneys from cadaveric donors in transplanted patients over 18 years of age in Argentina antigen adolescent adult anoxia Argentina cadaver kidney cause of death child chronic kidney failure coma conference paper controlled study data analysis software dialysis female graft survival head injury HLA system human kidney transplantation male mismatch negativity priority journal proportional hazards model school child sex difference stroke survival rate survival time tumor Background: With improvements in short-term kidney graft and patient survival, focus has shifted to understand patient and graft features that affect long-term survival. Materials and methods: This retrospective analysis from January 1998 to December 2009 employed Kaplan-Meier analysis to evaluate survival ratios at 30 days as well as 1, 5, and 10 years. A multivariable Cox regression model considered variables of donor and recipient, gender and age, cold ischemia time (CIT), chronic renal failure etiology, time on dialysis (TD) and cause of donor death. The mismatch (MM) value was coded according to the number of antigens shared by both the donor and the recipient for HLA-A, B, and DR. The MM values ranged between 0 and 6. Two groups were analyzed according the number of shared antigens: 0 to 3 versus 4 to 6. Results: Among 3030 (55.85%) males and 2395 (44.15%) females, the overall mean age was 46.9 ± 13.9 years. Median follow-up was 4 years (max 13 years). Patient survival rate (SR) was 97.5% at 30 days, 87.5% at 1 year, 74.5% at 5 years, and 59.2% at 10 years. Using Cox analysis, patient SR was affected by: diabetic nephropathy (DN) hazard ratio (HR) 1.55 (95% confidence interval [CI 95%] 1.21-1.97) P =.0005; head trauma (HT) cause of donor death HR 0.83 (0.73-0.95) P =.0005 and donor age (DA) compared by 18 to 44 years: 45 to 59 years HR 1.44 (CI95% 1.00-1.30) P =.043, >60 years HR 1.41 (CI95% 1.17-1.70) P =.0004. In addition relevant factors were recipient age (RA) compared by 18 to 44 years: 45 to 59 HR 1.99 (CI95% 1.74-2.27) P <.0001, >60 years HR 3.24 (CI95% 2.79-3.75) P <.0001 and DT >7 years HR 1.33 (CI95% 1.19-1.48) P =.0001. MM HLA 0 to 3 level HR 0.78 (CI95% 0.69-0.88) P <.0001. Graft SR was 95% at 30 days, 81.6% at 1 year, 64.7% at 5 years, and 47.3% at 10 years. The relevant factors were: DN HR 1.26 (CI95% 1.01-1.57) P =.04; HT HR 0.82 (0.74-0.91) P =.0004; DA compared by 18 to 44 years: 45-59 years HR 1.19 (CI95% 1.07-1.32) P =.002, >60 years HR 1.53 (CI95% 1.30-1.80) P <.0001; RA compared by 18 to 44 years: 45-59 HR 1.33 (CI95% 1.19-1.47) P <.0001, >60 years HR 1.84 (CI95% 1.63-2.09) P <.0001; DT > 7 years HR 1.22 (CI95% 1.11-1.35) P =.0001; CIT >24 hours HR 1.13 (CI95% 1.03-1.23) P =.009 and MM HLA 0 to 3 HR 0.82 (CI95% 0.74-0.91) P =.0002. Conclusion: HT as the cause of donor death and MM between 0 and 3 were associated with better patient and graft SR, DN, TD over 7 years, DA and RA over 45 were associated with lower patient SR. CIT > 24 hours, DN, TD over 7 years, as well as donor and recipient ages over 45 yr were associated with a lower graft SR. © 2012 Published by Elsevier Inc. 2012 https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_00411345_v44_n7_p2235_Bisigniano http://hdl.handle.net/20.500.12110/paper_00411345_v44_n7_p2235_Bisigniano
institution Universidad de Buenos Aires
institution_str I-28
repository_str R-134
collection Biblioteca Digital - Facultad de Ciencias Exactas y Naturales (UBA)
topic antigen
adolescent
adult
anoxia
Argentina
cadaver kidney
cause of death
child
chronic kidney failure
coma
conference paper
controlled study
data analysis software
dialysis
female
graft survival
head injury
HLA system
human
kidney transplantation
male
mismatch negativity
priority journal
proportional hazards model
school child
sex difference
stroke
survival rate
survival time
tumor
spellingShingle antigen
adolescent
adult
anoxia
Argentina
cadaver kidney
cause of death
child
chronic kidney failure
coma
conference paper
controlled study
data analysis software
dialysis
female
graft survival
head injury
HLA system
human
kidney transplantation
male
mismatch negativity
priority journal
proportional hazards model
school child
sex difference
stroke
survival rate
survival time
tumor
Factors associated with patient and graft survival using kidneys from cadaveric donors in transplanted patients over 18 years of age in Argentina
topic_facet antigen
adolescent
adult
anoxia
Argentina
cadaver kidney
cause of death
child
chronic kidney failure
coma
conference paper
controlled study
data analysis software
dialysis
female
graft survival
head injury
HLA system
human
kidney transplantation
male
mismatch negativity
priority journal
proportional hazards model
school child
sex difference
stroke
survival rate
survival time
tumor
description Background: With improvements in short-term kidney graft and patient survival, focus has shifted to understand patient and graft features that affect long-term survival. Materials and methods: This retrospective analysis from January 1998 to December 2009 employed Kaplan-Meier analysis to evaluate survival ratios at 30 days as well as 1, 5, and 10 years. A multivariable Cox regression model considered variables of donor and recipient, gender and age, cold ischemia time (CIT), chronic renal failure etiology, time on dialysis (TD) and cause of donor death. The mismatch (MM) value was coded according to the number of antigens shared by both the donor and the recipient for HLA-A, B, and DR. The MM values ranged between 0 and 6. Two groups were analyzed according the number of shared antigens: 0 to 3 versus 4 to 6. Results: Among 3030 (55.85%) males and 2395 (44.15%) females, the overall mean age was 46.9 ± 13.9 years. Median follow-up was 4 years (max 13 years). Patient survival rate (SR) was 97.5% at 30 days, 87.5% at 1 year, 74.5% at 5 years, and 59.2% at 10 years. Using Cox analysis, patient SR was affected by: diabetic nephropathy (DN) hazard ratio (HR) 1.55 (95% confidence interval [CI 95%] 1.21-1.97) P =.0005; head trauma (HT) cause of donor death HR 0.83 (0.73-0.95) P =.0005 and donor age (DA) compared by 18 to 44 years: 45 to 59 years HR 1.44 (CI95% 1.00-1.30) P =.043, >60 years HR 1.41 (CI95% 1.17-1.70) P =.0004. In addition relevant factors were recipient age (RA) compared by 18 to 44 years: 45 to 59 HR 1.99 (CI95% 1.74-2.27) P <.0001, >60 years HR 3.24 (CI95% 2.79-3.75) P <.0001 and DT >7 years HR 1.33 (CI95% 1.19-1.48) P =.0001. MM HLA 0 to 3 level HR 0.78 (CI95% 0.69-0.88) P <.0001. Graft SR was 95% at 30 days, 81.6% at 1 year, 64.7% at 5 years, and 47.3% at 10 years. The relevant factors were: DN HR 1.26 (CI95% 1.01-1.57) P =.04; HT HR 0.82 (0.74-0.91) P =.0004; DA compared by 18 to 44 years: 45-59 years HR 1.19 (CI95% 1.07-1.32) P =.002, >60 years HR 1.53 (CI95% 1.30-1.80) P <.0001; RA compared by 18 to 44 years: 45-59 HR 1.33 (CI95% 1.19-1.47) P <.0001, >60 years HR 1.84 (CI95% 1.63-2.09) P <.0001; DT > 7 years HR 1.22 (CI95% 1.11-1.35) P =.0001; CIT >24 hours HR 1.13 (CI95% 1.03-1.23) P =.009 and MM HLA 0 to 3 HR 0.82 (CI95% 0.74-0.91) P =.0002. Conclusion: HT as the cause of donor death and MM between 0 and 3 were associated with better patient and graft SR, DN, TD over 7 years, DA and RA over 45 were associated with lower patient SR. CIT > 24 hours, DN, TD over 7 years, as well as donor and recipient ages over 45 yr were associated with a lower graft SR. © 2012 Published by Elsevier Inc.
title Factors associated with patient and graft survival using kidneys from cadaveric donors in transplanted patients over 18 years of age in Argentina
title_short Factors associated with patient and graft survival using kidneys from cadaveric donors in transplanted patients over 18 years of age in Argentina
title_full Factors associated with patient and graft survival using kidneys from cadaveric donors in transplanted patients over 18 years of age in Argentina
title_fullStr Factors associated with patient and graft survival using kidneys from cadaveric donors in transplanted patients over 18 years of age in Argentina
title_full_unstemmed Factors associated with patient and graft survival using kidneys from cadaveric donors in transplanted patients over 18 years of age in Argentina
title_sort factors associated with patient and graft survival using kidneys from cadaveric donors in transplanted patients over 18 years of age in argentina
publishDate 2012
url https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_00411345_v44_n7_p2235_Bisigniano
http://hdl.handle.net/20.500.12110/paper_00411345_v44_n7_p2235_Bisigniano
_version_ 1768542497272758272

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