4.6 Article

Early Graft Loss After Kidney Transplantation: Risk Factors and Consequences

期刊

AMERICAN JOURNAL OF TRANSPLANTATION
卷 15, 期 6, 页码 1632-1643

出版社

WILEY
DOI: 10.1111/ajt.13162

关键词

clinical research; practice; kidney transplantation; nephrology; graft survival; donors and donation: donation after circulatory death (DCD)

资金

  1. Engineering and Physical Sciences Research Council [EP/J017213/1]
  2. EPSRC [EP/J017213/1] Funding Source: UKRI
  3. Engineering and Physical Sciences Research Council [EP/J017213/1] Funding Source: researchfish

向作者/读者索取更多资源

Early graft loss (EGL) after kidney transplantation is a catastrophic outcome that is assumed to be more likely after the use of kidneys from suboptimal donors. We therefore examined its incidence, risk factors and consequences in our center in relation to different donor types. Of 801 recipients who received a kidney-only transplant from deceased donors, 50 (6.2%) suffered EGL within 30 days of transplantation. Significant risks factors for EGL were donation after circulatory death (DCD) (odds ratio [OR] 2.88; p=0.006), expanded criteria donor (ECD) transplantation (OR 4.22; p=0.010), donor age (OR 1.03; p=0.044) and recipient past history of thrombosis (OR 4.91; p=0.001). Recipients with EGL had 12.28 times increased risk of death within the first year, but long-term survival was worse for patients remaining on the waiting list. In comparison with patients on the waiting list but not transplanted, and with all patients on the waiting list, the risk of death after EGL decreased to baseline 4 and 23 months after transplantation, respectively. Our findings suggest that DCD and ECD transplantation are significant risk factors for EGL, which is a major risk factor for recipient death. However, long-term mortality is even greater for those remaining on the waiting list.

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