Death with functioning kidney transplant: an obituarial analysis

Abstract

BackgroundDeath with a functioning kidney graft (DWFG) is now a major cause of graft loss after renal transplantation, occurring in up to 40% of cases. Its occurrence provides insight into the medical care of subjects with a functioning kidney transplant. In this study, we used the time to DWFG as an endpoint, to test whether improved medical care has contributed to better kidney transplant outcomes.MethodsWe used single-center data from the Milwaukee Regional Medical Center and Froedtert Hospital, on kidney-only transplants from 1969 through 2005. A total of 3,157 kidney transplants were done at our center during this time. There were 714 deaths with functioning kidney. We also recorded the major causes of DWFG over the time period from 1969 through 2005 divided into 3 epochs. The data were analyzed as a serial collection of yearly obituaries.ResultsThe time to DWFG has increased to 10 years despite a 20-year increase in the mean age of transplant recipients over the same time period.ConclusionsBetter pre-transplant evaluation, improved treatments for hypertension and hyperlipidemia, improved management of acute myocardial infarction, superior immunosuppressive protocols and better prophylaxis and treatment of infectious diseases have all likely contributed to this trend.

Función renal al fallecimiento según causa de muerte en trasplantados renales

“…En otras series de países en vías de desarrollo, en que las infecciones son la primera causa de MCRF, se ha planteado que las malas condiciones de higiene y retardo en la consulta al momento de sufrir infecciones contribuyen a la mortalidad por esta causa 23 . Se ha reportado que desde la década 1960-69 hasta ahora las infecciones han disminuido como causa de MCRF 8 .…”

“…La muerte con riñón funcionante (MCRF) actualmente es la causa principal de pérdida de los injertos, desplazando al agotamiento de la función del riñón trasplantado con regreso a la terapia dialítica [4][5][6] . La mejoría de los esquemas de inmunosupresión y del manejo de las enfermeda-des crónicas (principalmente cardiovasculares), así como el tratamiento de enfermedades infecciosas han prolongado la duración de los órganos trasplantados 7,8 .…”