PMID- 12777855
OWN - NLM
STAT- MEDLINE
DCOM- 20030623
LR  - 20071114
IS  - 0041-1337 (Print)
IS  - 0041-1337 (Linking)
VI  - 75
IP  - 10
DP  - 2003 May 27
TI  - Chronic allograft nephropathy uniformly affects recipients of cadaveric, 
      nonidentical living-related, and living-unrelated grafts.
PG  - 1677-82
AB  - BACKGROUND: Chronic allograft nephropathy (CAN) remains a major barrier to 
      long-term allograft survival. The authors retrospectively compared the 
      development of CAN in recipients of cadaveric (CAD), living-related donor (LRD), 
      and living-unrelated donor (LURD) transplants at their center. METHODS: The 
      authors retrospectively examined the impact of various factors on the incidence 
      of CAN using univariate and multivariate proportional hazards analysis in a 
      single-center kidney transplant population. RESULTS: Between 1 January 1990 and 
      31 May 2000, 2,140 kidney-alone transplants were performed at the authors' 
      center. The overall 5-year incidence of biopsy-proven CAN was 12.2% (n=203). Risk 
      factors for CAN included the number of transplants (P=0.0001), acute rejection 
      (P=0.0001), panel reactive antibody (P=0.0001), discharge creatinine (P=0.0001), 
      1-year creatinine (P=0.0015), delayed graft function (P=0.007), total human 
      leukocyte antigen (HLA)-B and -DR mismatches (P=0.0005), recipient age (P=0.003), 
      black donor race (P=0.001), black recipient race (0.0457), donor age (P=0.0053), 
      cold storage time (P=0.019), and cytomegalovirus infections (P=0.002). 
      Interestingly, although the LRD HLA-identical recipients had a significantly 
      lower incidence of CAN (P=0.0015), the incidence of CAN in CAD and 
      HLA-nonidentical LRD recipients did not differ. Graft survival was significantly 
      worse in CAD recipients compared with all other groups (P<0.001). CONCLUSIONS: 
      These results demonstrate the importance of immunologic and nonimmunologic 
      factors on the development of CAN. The disparities in overall graft survival, 
      despite the similarities in CAN rates, suggests that other factors, in addition 
      to CAN, influence the increase in graft loss in CAD transplant recipients.
FAU - Krieger, Nancy R
AU  - Krieger NR
AD  - Department of Surgery, University of Wisconsin Medical School, Madison, WI 
      53792-7375, USA.
FAU - Becker, Bryan N
AU  - Becker BN
FAU - Heisey, Dennis M
AU  - Heisey DM
FAU - Voss, Barbara J
AU  - Voss BJ
FAU - D'Alessandro, Anthony M
AU  - D'Alessandro AM
FAU - Becker, Yolanda T
AU  - Becker YT
FAU - Odorico, Jon S
AU  - Odorico JS
FAU - Kalayoglu, Munci
AU  - Kalayoglu M
FAU - Pirsch, John D
AU  - Pirsch JD
FAU - Sollinger, Hans W
AU  - Sollinger HW
FAU - Knechtle, Stuart J
AU  - Knechtle SJ
LA  - eng
GR  - K24 DK616962-01/DK/NIDDK NIH HHS/United States
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - Transplantation
JT  - Transplantation
JID - 0132144
SB  - IM
MH  - Adult
MH  - Biopsy
MH  - *Cadaver
MH  - Chronic Disease
MH  - *Family
MH  - Female
MH  - Graft Rejection/etiology
MH  - Graft Survival
MH  - Humans
MH  - Kidney/pathology
MH  - Kidney Diseases/complications/*etiology/mortality/pathology
MH  - Liver Transplantation/*adverse effects/mortality
MH  - *Living Donors
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Risk Factors
MH  - Survival Analysis
MH  - *Tissue Donors
MH  - Transplantation, Homologous/adverse effects
EDAT- 2003/06/05 05:00
MHDA- 2003/06/24 05:00
CRDT- 2003/06/05 05:00
PHST- 2003/06/05 05:00 [pubmed]
PHST- 2003/06/24 05:00 [medline]
PHST- 2003/06/05 05:00 [entrez]
AID - 10.1097/01.TP.0000063830.60937.06 [doi]
PST - ppublish
SO  - Transplantation. 2003 May 27;75(10):1677-82. doi: 
      10.1097/01.TP.0000063830.60937.06.