Causes of Death After Kidney Transplantation

Abstract

Durtng the five-year period September 1074 through August '1979"two to the many physicians outside transhundred nine consecutive patients rec,lved their first kidney transplant In plant ~nterswho are now caring for Denver. During 2.5 to 7.5' years of foDow-up. 54 paUents (28%) died. kidney transplant patients. Infection was the leading cause of death during .. Interval. and was METHODS re.ponslble for 22 (41%) of the 54 deaths. Pneumonia was prtmarUy We, have reviewed the results of 209 re.ponslble for 14 of the 22 deaths from Infection. The other cau.e. of death CODSeCUtive patients who received their were cardiovascular problems In11 patient. (20%), suicide In eight paUents first kidney transplant at the University (15%). gastrOintestinal (GI) tract problems In .. ven paUents (13%), mangnsnt of Colorado Health Sciences Center and neopla.ms In two patient. (4%), and miscellaneous probIems-ln-four-paUentsthe Dcm¥R VeterlUlLAdminiatntioQ Hoe----' ,-'(7%). Twenty-alx ,(48%) of the 54 deaths occurred more than one year after pital during the fi.,.-year period Septemprtmary'transplantatlon; 12 of these 28 patlenla had already returned to ber 19"l4 throush August 1979. By meaDS of inpatient chart review, outpatient chart chronic hemodialysis. To minimize mortality atter transplantation, patients review, and telephone calldo patients and and their physician. must remain alert to the ongoing rt.ks to which the.. ,families, follow-up information for all paUent. are exposed, Including the rI.ks of sudden death from Infection.patients has been updated to Feb 1. U82. myocardial Infarction, pulmonary embolu., SUicide, or GI tract perforation. ~ range .or,foU cnr -Il P for the.155 lllniv-(JAifA 1983;250:4~54) • .. " ' / . 0 . patients ia 2.5 to 1.5, JUI'I (mean, 58 . ,. . months). Patients• _ho received a lint _ . ~ -' '~Diney transplaDt before •September 19'14

Immunosuppressant dose reduction and long-term rejection risk in renal transplant recipients with severe bacterial pneumonia

“…(3) Although the incidence of pneumonia is lower for kidney transplantation than all other organ grafts, pneumonia is a common and serious infectious complication in renal transplant recipients (RTRs), possibly leading to respiratory failure, with mortality rates of up to 50%. (4)(5)(6) In part due to their frequent contact with the healthcare system and immunosuppressive status, RTRs may have more resistant organisms, thus leading to the potential development of more fulminant and virulent pneumonia in these patients. While the development of novel immunosuppressive drugs has decreased the risk of acute rejection and improved long-term outcome, a lack of drug management and immune modulation has been reported to result in severe infectious conditions in RTRs.…”

Changes in Left Ventricular Mass and Filling after Renal Transplantation Are Related to Changes in Blood Pressure: An Echocardiographic and Pulsed Doppler Study

“…Patients with chronic renal failure (CRF) may have cardiovascular problems as a result of chronic anemia, hypertension, patent arte riovenous Fistula and excess of liquids and electrolytes [1][2][3]. In addition, left ventricular hypertrophy (LVH), usually present in these patients is an independent risk factor for car diovascular morbidity and mortality [4,5].…”

Psychiatric Morbidity in Renal Transplantation

“…Some studies have reported that more than 50% of transplanted patients suffer from anxiety, even some years after trans plantation [ 1,2], In one consecutive series of transplant recipients, 15% were claimed to have committed suicide within the follow-up period [3]. Several studies have reported that transplanted patients fare no better than those on dialysis in terms of quality of life [4] or prevalence of minor psychiatric morbid ity [5].…”