Recipient Criteria Predictive of Graft Failure in Kidney Transplantation

Abstract

Several classifications systems have been developed to predict outcomes of kidney transplantation based on donor variables. This study aims to identify kidney transplant recipient variables that would predict graft outcome irrespective of donor characteristics. All U.S. kidney transplant recipients between October 25,1999 and January 1, 2007 were reviewed. Cox proportional hazards regression was used to model time until graft failure. Death-censored and nondeath-censored graft survival models were generated for recipients of live and deceased donor organs. Recipient age, gender, body mass index (BMI), presence of cardiac risk factors, peripheral vascular disease, pulmonary disease, diabetes, cerebrovascular disease, history of malignancy, hepatitis B core antibody, hepatitis C infection, dialysis status, panel-reactive antibodies (PRA), geographic region, educational level, and prior kidney transplant were evaluated in all kidney transplant recipients. Among the 88,284 adult transplant recipients the following groups had increased risk of graft failure: younger and older recipients, increasing PRA (hazard ratio [HR],1.03?1.06], increasing BMI (HR, 1.04?1.62), previous kidney transplant (HR, 1.17?1.26), dialysis at the time of transplantation (HR, 1.39?1.51), hepatitis C infection (HR, 1.41?1.63), and educational level (HR, 1.05?1.42). Predictive criteria based on recipient characteristics could guide organ allocation, risk stratification, and patient expectations in planning kidney transplantation.

Healthcare Resource Use, Cost, and Sick Leave Following Kidney Transplantation in Sweden: A Population-Based, 5-Year, Retrospective Study of Outcomes: COIN

“…Furthermore, a history of HD was associated with more outpatient visits compared with patients who were not in dialysis (preemptive patients). This is consistent with observations that prior kidney transplantation and a history of HD are important predictors of post-transplantation outcomes [17,19]. It is possible that patients with a history of transplantation and HD were in worse health prior to transplantation and, therefore, more prone to post-transplantation complications than those who were transplantation-naïve and pre-emptive transplant patients.…”

“…Various studies have shown that outcomes are better for patients who receive their kidney from a living rather than from a deceased donor [10,17–19]. In line with these findings, we observed that patients who received a graft from a deceased donor had higher levels of long-term sick leave after transplantation.…”

A retrospective study of the relationship between postoperative urine output and one year transplanted kidney function

“…Risk factors measured in this study were age, hypertension and HLA mismatch. Recipient risk factors associated with graft failure include age, increasing plasma renin activity, BMI, prior transplant, dialysis at the time of KT, and hepatitis C virus infection [32]. Our study also showed that recipient height, weight and BMI affect graft function.…”

Assessment of risk factors for increased resource utilization in kidney transplantation

“…Recent studies have identified risk factors for graft failure include extremes of age, high PRA, increasing body mass index, previous kidney transplant, dialysis at time of transplant, hepatitis C infection, and educational level. 13 Adaptations can be made to the survey used in our study to reflect the aforementioned associations.…”