Effect of Age on The Outcome of Renal Transplantation: A Single-Center Experience

Özkul, Faruk; Erbiş, Halil; Yılmaz, Vural Taner; Koçak, Hüseyin; Osmanoğlu, Ibrahim Ali; Dınçkan, Ayhan

doi:10.12669/pjms.324.10094

Cited by 14 publications

(16 citation statements)

References 11 publications

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“…10 Another study also found the 5-year survival rate of kidney transplant subjects in the non-geriatric category was 90% compared to the geriatric category survival of 82%. 11 In this study, the geriatric subjects were found to have higher 5-year survival outcomes (94.7% vs 89.5%). The explanation for this result could be that geriatric patients have a lower chance of rejection due to a weaker immune system, leading to less immunosuppressive therapy.…”

Section: Discussionmentioning

confidence: 57%

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Survival Rate of Living Related Kidney Transplant Patients in Surabaya

Medika

Aditiawardana

Pranawa

et al. 2019

Indones J Kidney Hypertens

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Background The survival outcome of transplant patients have improved in the past three decades. The short and long term survival of grafts and patients are still being widely studied. Many factors affect the survival rate such as age, gender, diabetes mellitus, and immunosuppressive therapy. Objective The study aimed to provide patients' survival rates 1, 3, and 5 years after transplant. Methods The study used a descriptive approach to 67 kidney transplant patients undergoing outpatient treatment from 1996 to 2016. The data collected were analyzed using SPSS with the Kaplan-Meier curve to observe the survival rate. Result: The survival rate of patients in 1, 3, and 5 years were 100%, 97%, and 94% respectively. The survival rate in geriatric and non-geriatric patients in the first year post-transplantation was both 100%, the third year post-transplantation survival rate was 100% and 94.7%, and the five year post-transplantation survival rate were 100% and 89.5%. The survival rate of patients receiving tacrolimus vs cyclosporine were both 100% in the first year, 97.1% vs 97% in the third year, and 97.1% vs 90.9% in the fifth year after transplant. Conclusion The survival rate of kidney transplant patients in 1, 3, and 5 years after transplant were 100%, 97%, and 94%. Geriatric patients and patients who received tacrolimus have the tendency for a higher survival rate. Further study with a bigger sample and appropriate design is needed to determine the risk factors for kidney transplant patients' survival.

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Section: Discussionmentioning

confidence: 57%

“…10 This is yet to be elucidated, but the latest study has found that acute graft rejection was found higher in non-geriatric patients, further supporting the role of the lower immune system in geriatric patients survival. 11 Distribution of age between the subjects is also a confounding factor that needs to be considered.…”

Section: Discussionmentioning

confidence: 99%

Survival Rate of Living Related Kidney Transplant Patients in Surabaya

Medika

Aditiawardana

Pranawa

et al. 2019

Indones J Kidney Hypertens

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“…Our results suggest, like other studies evaluating the effect of race on renal transplant outcomes, that the Asian Hmong population on the whole had a reduced degree of sensitization, which may result in reduced rejection risk, and overall lower immunosuppressive burden which translates into favorable infection and patient and graft survival rates . Finally, younger age at time of transplant is thought to be associated with reduced complications after transplant and improved survival outcomes . However, the disparities between the study populations alone do not explain the non‐inferior outcomes in the Hmong population.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of infectious risk and outcomes in the hmong renal transplant population

Jorgenson

Cardinale

Descourouez

et al. 2019

Transplant Infectious Dis

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Background: Hmong ethnicity has been associated with infection, particularly fungal.The risk of infection after transplant in the Hmong population is unknown.Methods: Observational study of adult renal transplant (RTX) recipients between 1/1/1994 and 12/31/2015. Primary objective was to identify infectious risk in the Hmong RTX population as compared to non-Hispanic whites (NHW). Secondary objective was to evaluate transplant outcomes. Results:There was a total of 2599 patients in the study window; 95 Hmong, 2504 NHW. The Hmong population had significantly fewer bacterial and fungal infections at 1 and 3 years (Bacterial: Hmong 21.7%, 32.4% vs NHW 36.9%, 46.7%, P = .004; Fungal: Hmong 3.3%, 5.7% vs NHW 12.7%, 16.6%, P = .0005) and improved graft and patient survival at 1, 5, and 10 years (Graft: Hmong 92.6%, 78.4%, 61.9% vs NHW 90.7%, 72.2%, 48.5%, P = .006; Patient: Hmong 97.8%, 94.5%, 83.3% vs NHW 95.3%, 82.1%, 62.1% P < .001). Spectrum of bacterial infection was similar, but with significantly more Staphylococcal infection in the NHW population. Blastomycoses were the major fungal pathogen in Hmong (2/3, 67%) vs Candida in NWH (77%).When minimally adjusted for PRA and age, rates of bacterial infection (HR 0.69, 95% CI 0.48-0.99, P = .047), fungal infection (HR 0.39, 95% CI 0.17-0.87, P = .02), and mortality (HR 0.5, 95% CI 0.28-0.88, P = .02) were more favorable in the Hmong population. When analyzed in a stepwise Cox proportional hazards model; Hmong ethnicity was not a significant risk factor for graft failure, rejection, CMV, BK, or fungal infection after RTX and was associated with reduced risk of bacterial infection (HR 0.61, 95% CI 0.4-0.9, P = .02) and mortality (HR 0.51, 95% CI 0.27-0.96, P = .04). Conclusions:Despite concern regarding infective risk in the Hmong population, infection after RTX is no higher than NHW comparator. In all analyses, the Hmong population has equal or better outcomes. It does not appear variance in standard infection prophylaxis is necessary for the Hmong population after RTX.

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“…triggering postoperative DGF is higher. 20,21 The risk of DGF is also proportional to R-BMI. Hill et al 22 reported that obese patients (BMI≥30kg/m 2 ) are more likely to suffer from DGF than normal patients (18.5kg/m 2 -≤BMI≤24.9 kg/m 2 ).…”

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confidence: 99%

Development and Validation of Nomogram for Predicting Delayed Graft Function After Kidney Transplantation of Deceased Donor

Pan¹,

Liao²

2021

IJGM

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Background: Delayed graft function (DGF) is a major complication of kidney transplantation (KT), especially in patients receiving donor of decease (DD) KT. Therefore, the kidney donor pool is rare worldwide, it is critical to evaluate the risk coefficient of DGF using preoperative data of donors and recipients and provide a reference for clinical decisionmaking and resource allocation. Method and Analysis: A total of 238 DD recipients were performed in our center. Finally, 211 patients were included. The clinical database was divided into 34 clinical blood indicators (CBIs) and 6 demographics indexes (DIs). CBIs and DIs were screened for variables with P<0.05 and demonstrated the best cut-off value using multivariable logistics regression. The selected CBIs were passed through the least absolute shrinkage and selection operator (LASSO) to obtain the predictive factors and synthesized into a Riskscore, forming a nomogram with the selected DIs. We used receiver operating characteristic (ROC), calibration, and decision curve analysis (DCA) to verify the discrimination and clinical effects of this nomogram. Finally, 10-fold cross-validation was conducted internally to show the effect of the model. Results:The 34 CBIs of the database finally screened out 12 predictors, which were synthesized into Riskscore. The 6 DIs selected 3 variables. Riskscore and 3 DIswere constructed into a nomogram, and the ROC of the nomogram has an AUC value of 0.725. Calibration and DCA showed excellent verification effects on the nomogram. The 10-fold crossover internal validation also demonstrated the model's excellent discrepancy. Conclusion:The nomogram has an excellent ability to predict DGF and provides an essential reference for decision-making and resource allocation in a clinical setting.

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Effect of Age on The Outcome of Renal Transplantation: A Single-Center Experience

Cited by 14 publications

References 11 publications

Survival Rate of Living Related Kidney Transplant Patients in Surabaya

Survival Rate of Living Related Kidney Transplant Patients in Surabaya

Evaluation of infectious risk and outcomes in the hmong renal transplant population

Development and Validation of Nomogram for Predicting Delayed Graft Function After Kidney Transplantation of Deceased Donor

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