PMID- 19917364
OWN - NLM
STAT- MEDLINE
DCOM- 20100224
LR  - 20220318
IS  - 1873-2623 (Electronic)
IS  - 0041-1345 (Linking)
VI  - 41
IP  - 9
DP  - 2009 Nov
TI  - Risk factors associated with graft loss and patient survival after kidney 
      transplantation.
PG  - 3667-70
LID - 10.1016/j.transproceed.2009.04.013 [doi]
AB  - OBJECTIVE: To evaluate the influence of traditional risk factors on major kidney 
      transplantation outcome. PATIENTS AND METHODS: Data from kidney transplantation 
      procedures performed between 2003 and 2006 were retrospectively analyzed for the 
      influence of traditional risk factors on transplantation outcome. Of 2364 
      transplants, 67% were from living donors, 27% were from donors who met standard 
      criteria, and 6% were from donor who met expanded criteria. Two hundred 
      thirty-nine procedures (10%) were performed in pediatric patients. 
      Immunosuppression was selected on the basis of subgroup population. RESULTS: At 1 
      year posttransplantation, cumulative freedom from a treated acute rejection 
      episode (ARE) was 76.7%, with no difference between black vs nonblack recipients 
      (75.0% vs 73.4%; P = .79). At 2 years, survival for patients (95.3% vs 88.3% vs 
      82.1%; P < .001) and grafts 92.3% vs 80.3% vs 70.9%; P < .001) was better in 
      recipients of living donor grafts compared with donors who met standard or 
      expanded criteria, respectively. Moreover, graft survival was poorer in black vs 
      nonblack patients (83.6% vs 88.7%; P < .05) because of high mortality (13% vs 7%; 
      P<.001). Risk factors associated with death included cadaveric donor organ (odds 
      ratio [OR], 2.4) and black race (OR, 1.8), and risk factors associated with graft 
      loss included cadaveric donor organ (OR, 2.1), extended-criteria criteria donor 
      organ (OR, 2.0), delayed graft function (OR, 1.8), and any ARE (OR, 3.5). At 6 
      months posttransplantation, risk factors associated with death included cadaveric 
      donor organ (OR, 2.5) or ARE (OR, 2.4), and risk factors associated with graft 
      loss included cadaveric donor organ (OR, 2.0), extended-criteria donor organ (OR, 
      2.6), ARE (OR, 9.5), and impaired graft function (creatinine concentration >1.5 
      mg/dL; OR, 2.1). CONCLUSION: Traditional risk factors are still associated with 
      transplantation outcome. Poorer graft survival in black vs nonblack recipients 
      was due to higher mortality rather than graft loss.
FAU - Harada, K M
AU  - Harada KM
AD  - Division of Nephrology, Hospital do Rim e Hipertensao, Universidade Federal de 
      Sao Paulo, Sao Paulo, Brazil. kelly.harada@medfarm.com.br
FAU - Mandia-Sampaio, E L
AU  - Mandia-Sampaio EL
FAU - de Sandes-Freitas, T V
AU  - de Sandes-Freitas TV
FAU - Felipe, C R
AU  - Felipe CR
FAU - Park, S I
AU  - Park SI
FAU - Pinheiro-Machado, P G
AU  - Pinheiro-Machado PG
FAU - Garcia, R
AU  - Garcia R
FAU - Tedesco-Silva, H Jr
AU  - Tedesco-Silva H Jr
FAU - Medina-Pestana, J O
AU  - Medina-Pestana JO
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Transplant Proc
JT  - Transplantation proceedings
JID - 0243532
SB  - IM
MH  - Adult
MH  - Body Mass Index
MH  - Ethnicity
MH  - Female
MH  - Follow-Up Studies
MH  - Graft Rejection/epidemiology
MH  - Humans
MH  - Kidney Failure, Chronic/etiology/surgery
MH  - Kidney Transplantation/adverse effects/mortality/*physiology
MH  - Living Donors/statistics & numerical data
MH  - Male
MH  - Patient Selection
MH  - Racial Groups
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Survival Rate
MH  - Survivors
MH  - Time Factors
MH  - Treatment Failure
EDAT- 2009/11/18 06:00
MHDA- 2010/02/25 06:00
CRDT- 2009/11/18 06:00
PHST- 2008/10/31 00:00 [received]
PHST- 2009/04/13 00:00 [accepted]
PHST- 2009/11/18 06:00 [entrez]
PHST- 2009/11/18 06:00 [pubmed]
PHST- 2010/02/25 06:00 [medline]
AID - S0041-1345(09)01411-0 [pii]
AID - 10.1016/j.transproceed.2009.04.013 [doi]
PST - ppublish
SO  - Transplant Proc. 2009 Nov;41(9):3667-70. doi: 10.1016/j.transproceed.2009.04.013.