Comparison of Survival Probabilities for Dialysis Patients vs Cadaveric Renal Transplant Recipients

Port, Friedrich K.; Wolfe, Robert A.; Mauger, Elizabeth A.; Berling, Donald P.; Jiang, Kaihong

doi:10.1001/jama.1993.03510110079036

Cited by 648 publications

(308 citation statements)

References 14 publications

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“…Kidney transplantation offers a survival advantage over dialysis treatment in essentially all patient subgroups 1,2 ; however, the survival of kidney transplant recipients (KTR) is inferior to that of the general population. 3 Although early kidney dysfunction has a clear adverse effect on long-term allograft survival, there are fewer data on the relationship between early graft function and patient survival.…”

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confidence: 99%

Delayed Graft Function and the Risk for Death with a Functioning Graft

Tapiawala

Tinckam

Cardella

et al. 2010

Journal of the American Society of Nephrology

179

137

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Delayed graft function (DGF) associates with an increased risk for graft failure, but its link with death with graft function (DWGF) is unknown. We used the US Renal Data System to assemble a cohort of all first, adult, deceased-donor kidney transplant recipients from January 1, 1998, through December 31, 2004. In total, 11,542 (23%) of 50,246 recipients required at least one dialysis session in the first week after transplantation. Compared with patients without DGF, patients with DGF were significantly more likely to die with a functioning graft (relative hazard 1.83 [95% confidence interval 1.73 to 1.93] and 1.53 [95% CI 1.45 to 1.63] for unadjusted and fully adjusted models, respectively). The risk for DWGF was slightly higher among women with DGF than among men. There was no significant heterogeneity among other subgroups, and the results were robust to sensitivity analyses. Acute rejection within the first year attenuated the DGF-DWGF association. Cardiovascular and infectious deaths were slightly more prevalent in the DGF group, but the relative hazards of cause-specific death were similar between DWGF and deaths during total follow-up. In summary, DGF associates with an increased risk for DWGF; the mechanisms underlying the negative impact of DGF require further study.

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confidence: 99%

Delayed Graft Function and the Risk for Death with a Functioning Graft

Tapiawala

Tinckam

Cardella

et al. 2010

Journal of the American Society of Nephrology

179

137

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“…1,2 The scarcity of organs from deceased donors had encouraged living kidney donation programs. 3 Cultural differences and public policies strongly influence this issue, namely a lack of legislation in some developing countries regarding donation from deceased donors.…”

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confidence: 99%

Depression and Anxiety in Living Kidney Donation: Evaluation of Donors and Recipients

Lopes

Frade

Teixeira³

et al. 2011

Transplantation Proceedings

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Background. Psychosocial status of donors before and after living kidney donor transplantation has been an important concern. Investigations of psychosocial issues in related recipients are not frequent. Aim. The aims of this study were to evaluate and compare psychopathologic dimensions in donors and recipients before and after transplantation. Methods. Thirty-five recipients and 45 donors completed a psychosocial evaluation before and after transplantation. We applied Pearson chi-square, McNemar, Fisher, Wilcoxon, and Mann-Whitney tests as well as linear and logistic regression statistical methods.Results. Before transplantation 100% of the recipients presented total anxiety, compared with 64.4% of donors, with higher anxiety levels in all dimensions (P Ͻ .001). Also, 38.7% of recipients and 16.3% of donors had moderate/serious depression (P ϭ .029). Men showed higher levels of cognitive anxiety before transplantation (odds ratio [OR] ϭ 4.3; P ϭ .008). After versus before transplantation central nervous system and cognitive anxiety had diminished in recipients (P ϭ .031; P ϭ .035, respectively); there were higher levels of cognitive anxiety than among the donors (P ϭ .007). Depression showed no significant changes in recipients or donors; the differences were no longer significant. There were less severely depressed recipients but an increase among severely depressed donors. Male recipients and donors showed greater cognitive anxiety (P ϭ .02; P ϭ .04, respectively) at both times. Female recipients presented with more severe depression (P ϭ .036). Conclusions. Anxiety is an important symptom. Surgery had a positive impact to lower anxiety in recipients. Most protagonists displayed little or no depression; it was more prevalent among recipients. Donors and recipients maintained some psychopathologic symptoms after surgery. We defined vulnerable groups among these cohorts.

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“…Las terapias renales sustitutivas (TRS) constituyen la alternativa disponible para su tratamiento; siendo el trasplante renal la mejor opción terapéutica según los profesionales de la salud 2 . Sin embargo, el mismo se ve limitado por múltiples factores, destacando la poca disponibilidad de órganos, sus costos elevados y la carencia de recursos económicos.…”

Section: Cad Saúde Pública 2017; 33(10):e00160416unclassified

La atención a la enfermedad renal en Uruguay: la perspectiva de individuos con trasplante renal

Mercado-Martínez

Levin-Echeverri

2017

Cad. Saúde Pública

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Resumen: Este trabajo examina la atención renal desde la perspectiva de quienes han sido trasplantados, padeciendo enfermedad renal crónica (ERC), así como la de sus familias. Se realizó un estudio cualitativo en tres ciudades de Uruguay. Utilizando un muestreo teórico, seleccionamos 25 personas con ERC que vivieran con trasplante renal, y cinco familiares. Se hicieron entrevistas semi-estructuradas para explorar las perspectivas de los participantes; así como análisis de contenido. Cuatro ejes temáticos fueron construidos a partir del discurso de los participantes: reconociendo los logros del sistema de atención, teniendo derecho a la salud, identificando problemas en la atención y formulando propuestas de acción. El sistema de atención es considerado adecuado, eficiente y de calidad por quienes viven con trasplante renal, son jóvenes, trabajadores, de Montevideo y están cubiertos por el sector sanitario privado. Lo contrario sucede con los jubilados o pensionistas, con multi-morbilidad, del interior del país, cubiertos por el sector público y viviendo en la pobreza. Los participantes también formulan propuestas para resolver los problemas identificados. Además de reconocer el acceso gratuito y universal a las terapias renales, a las cuales consideran tener derecho, concluimos que los individuos con trasplante de riñón valoran favorablemente la atención sanitaria y los organismos involucrados. Sin embargo, algunos enfrentan serios obstáculos para acceder a una atención gratuita, oportuna y de calidad. Recomendamos impulsar estrategias para incorporar propuestas de los individuos enfermos y sus familias, a fin de mejorar dicha atención y disminuir las desigualdades sociales.

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Comparison of Survival Probabilities for Dialysis Patients vs Cadaveric Renal Transplant Recipients

Cited by 648 publications

References 14 publications

Delayed Graft Function and the Risk for Death with a Functioning Graft

Delayed Graft Function and the Risk for Death with a Functioning Graft

Depression and Anxiety in Living Kidney Donation: Evaluation of Donors and Recipients

La atención a la enfermedad renal en Uruguay: la perspectiva de individuos con trasplante renal

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