期刊
AMERICAN JOURNAL OF TRANSPLANTATION
卷 21, 期 10, 页码 3333-3345出版社
ELSEVIER SCIENCE INC
DOI: 10.1111/ajt.16605
关键词
clinical research; practice; health services and outcomes research; kidney transplantation; nephrology; patient survival; registry; registry analysis
资金
- National Institute of Diabetes and Digestive and Kidney Disease (NIDDK)
- National Institute on Aging (NIA) [R01DK120518, R01AG055781, R01 AG055781-02S1, K24AI144954]
The study revealed that fine particulate matter PM2.5 is associated with adverse outcomes in kidney transplant recipients, including delayed graft function, 1-year acute rejection, and increased risk of mortality.
Fine particulate matter (PM2.5), a common form of air pollution which can induce systemic inflammatory response, is a risk factor for adverse health outcomes. Kidney transplant (KT) recipients are likely vulnerable to PM2.5 due to comorbidity and chronic immunosuppression. We sought to quantify the association between PM2.5 and post-KT outcomes. For adult KT recipients (1/1/2010-12/31/2016) in the Scientific Registry of Transplant Recipients, we estimated annual zip-code level PM2.5 concentrations at the time of KT using NASA's SEDAC Global PM2.5 Grids. We determined the associations between PM2.5 and delayed graft function (DGF) and 1-year acute rejection using logistic regression and death-censored graft failure (DCGF) and mortality using Cox proportional hazard models. All models were adjusted for sociodemographics, recipient, transplant, and ZIP code level confounders. Among 87 233 KT recipients, PM2.5 was associated with increased odds of DGF (OR = 1.59; 95% CI: 1.48-1.71) and 1-year acute rejection (OR = 1.31; 95% CI: 1.17-1.46) and increased risk of all-cause mortality (HR = 1.15; 95% CI: 1.07-1.23) but not DCGF (HR = 1.05; 95% CI: 0.97-1.51). In conclusion, PM2.5 was associated with higher odds of DGF and 1-year acute rejection and elevated risk of mortality among KT recipients. Our study highlights the importance of considering environmental exposure as risk factors for post-KT outcomes.
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