Effect of donor and recipient variables on the long-term live-donor renal allograft survival in children

Wafa, Ehab W.; Shokeir, Ahmed A.; Akl, Ahmed; Hassan, Nabil; Fouda, Mohamed A.; Dahshan, Kalid El; Ghoneim, Mohamed A.

doi:10.1016/j.aju.2011.07.003

Cited by 6 publications

(11 citation statements)

References 24 publications

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“…The difference between the findings of this present study and these previous studies could be linked to differences in sample size (number of graft failures observed), year of transplant, duration of follow-up and method of data analysis. Nevertheless, it is noteworthy that the significant predictors of GS observed in this study are in agreement with previous studies (11, 16–18, 34, 35, 37, 38).…”

Section: Discussionsupporting

confidence: 93%

See 1 more Smart Citation

Modeling Long-Term Graft Survival With Time-Varying Covariate Effects: An Application to a Single Kidney Transplant Centre in Johannesburg, South Africa

Achilonu

Fabian

Musenge

2019

Front. Public Health

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Objectives: Patients' characteristics that could influence graft survival may also exhibit non-constant effects over time; therefore, violating the important assumption of the Cox proportional hazard (PH) model. We describe the effects of covariates on the hazard of graft failure in the presence of long follow-ups. Study Design and Settings: We studied 915 adult patients that received kidney transplant between 1984 and 2000, using Cox PH, a variation of the Aalen additive hazard and Accelerated failure time (AFT) models. Selection of important predictors was based on the purposeful method of variable selection. Results: Out of 915 patients under study, 43% had graft failure by the end of the study. The graft survival rate is 81, 66, and 50% at 1, 5, and 10 years, respectively. Our models indicate that donor type, recipient age, donor-recipient gender match, delayed graft function, diabetes and recipient ethnicity are significant predictors of graft survival. However, only the recipient age and donor-recipient gender match exhibit constant effects in the models. Conclusion: Conclusion made about predictors of graft survival in the Cox PH model without adequate assessment of the model fit could over-estimate significant effects. The additive hazard and AFT models offer more flexibility in understanding covariates with non-constant effects on graft survival. Our results suggest that the period of follow-up in this study is long to support the proportionality assumption. Modeling graft survival at different time points may restrain the possibility of important covariates showing time-variant effects in the Cox PH model.

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Section: Discussionsupporting

confidence: 93%

“…GF rates were computed as the ratio of the number of failed grafts to patient-years (PY) of follow-up and expressed as failure rates per 1,000 PY. Predictor variables or covariates for inclusion in this study were identified from literature using factors shown to significantly influence graft survival (16–18).…”

Section: Methodsmentioning

confidence: 99%

Modeling Long-Term Graft Survival With Time-Varying Covariate Effects: An Application to a Single Kidney Transplant Centre in Johannesburg, South Africa

Achilonu

Fabian

Musenge

2019

Front. Public Health

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“…The renal transplantation at our center was from living donor, majority from LRD (parents). Living donor transplant is reported to have better survival outcomes for pediatric recipients irrespective of donor age and should be recommended whenever possible . Immunosuppression protocols followed at our center are in accordance with the current practices and guidelines followed across the world…”

Section: Discussionmentioning

confidence: 92%

“…Living donor transplant is reported to have better survival outcomes for pediatric recipients irrespective of donor age and should be recommended whenever possible. 13,17,18 Immunosuppression protocols followed at our center are in accordance with the current practices and guidelines followed across the world. 12,13 Most recipients in our study had a negative history of post-trans- The graft survival rates observed at our center were 96.7% probabilities for recipients from LRD were 94%, 83%, and 77% at 1, 5, and 7 years post-transplant, respectively.…”

Section: Effect Of Transplantation On Renal Functionmentioning

confidence: 99%

Good outcome of the single‐center pediatric kidney transplant program in Abu Dhabi

Kumar

Al-Ismaili

Ilyas

et al. 2019

Pediatric Transplantation

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Renal transplantation is the treatment of choice for ESRD in children. It is associated with better quality of life, growth of children, and improved long‐term survival. The aim of the study was to evaluate the outcomes of pediatric renal transplantation at a tertiary care center in UAE. A retrospective chart review was undertaken for all the pediatric renal transplants performed at Sheikh Khalifa Medical City, Abu Dhabi, UAE, over the past 9 years. The study evaluated the demographic data, outcomes, and complications of pediatric renal transplantation. The post‐transplantation outcomes including surgical complications, documented infections, graft rejection, graft and patient survival, effect on growth, and eGFR were reviewed. Between 2010 and 2018, 30 pediatric patients underwent renal transplantation. The follow‐up period ranged from 1 to 9 years with a mean of 3.3 years. The mean age of the patients at the time of transplant was 9.8 years, and 56.7% were males. Prior to the transplantation, the majority of the recipients were on peritoneal dialysis (70.0%). Main source of renal donation at our center was from LRD, chiefly from parents. Patient survival at 1 and 5 years was 100% and 96.7%, respectively. Graft survival at 1 and 5 years was 96.7% and 83.3%, respectively. During the 9‐year follow‐up period, 5 (16.7%) recipients experienced rejection episode. This study demonstrates that during 5‐year period, pediatric kidney transplantation program has achieved optimal patient (96.7%) and graft (83.3%) survival rates and is comparable to well‐established centers.

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“…Jacobs et al [ 11 ] compared graft survival between male and female transplant recipients at one- and three-years post-transplantation. Wafa et al [ 12 ] compared graft survival between male and female recipients at five- and 10- years post-transplantation. Both studies found no significant difference in short- and long-term graft survivals between male and female transplant recipients, also showing no significant difference between graft survival in transplant recipients who were the same gender as the donor and transplant recipients who were of a opposite gender as their donor.…”

Section: Resultsmentioning

confidence: 99%

The Impact of Recipient Demographics on Outcomes from Living Donor Kidneys: Systematic Review and Meta-Analysis

Bellini

Nozdrin

Pengel

et al. 2021

JCM

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Background and Aims: Recipient demographics affect outcomes after kidney transplantation. The aim of this study was to assess, for kidneys retrieved from living donors, the effect of recipient sex, ethnicity, and body mass index (BMI) on delayed graft function (DGF) and one-year graft function, incidence of acute rejection (AR), and recipient and graft survivals. Methods: A systematic review and meta-analysis was performed. EMBASE and MEDLINE databases were searched using algorithms through Ovid. Web of Science collection, BIOSIS, CABI, Korean Journal database, Russian Science Citation Index, and SciELO were searched through Web of Science. Cochrane database was also searched. Risk of bias was assessed using the NHBLI tools. Data analysis was performed using Revman 5.4. Mean difference (MD) and risk ratio (RR) were used in analysis. Results: A total of 5129 studies were identified; 24 studies met the inclusion criteria and were analysed. Female recipients were found to have a significantly lower serum creatinine 1-year-post renal transplantation (MD: −0.24 mg/dL 95%CI: −0.18 to −0.29 p < 0.01) compared to male recipients. No significant difference in survival between male and female recipients nor between Caucasians and Africans was observed (p = 0.08). However, Caucasian recipients had a higher 1-year graft survival compared to African recipients (95% CI 0.52−0.98) with also a lower incidence of DGF (RR = 0.63 p < 0.01) and AR (RR = 0.55 p < 0.01). Recipient obesity (BMI > 30) was found to have no effect on 1-year recipient (p = 0.28) and graft survival (p = 0.93) compared to non-obese recipients although non-obese recipients had a lower rate of DGF (RR = 0.65 p < 0.01) and AR (RR = 0.81 p < 0.01) compared to obese recipients. Conclusions: Gender mismatch between male recipients and female donors has negative impact on graft survival. African ethnicity and obesity do not to influence recipient and graft survival but negatively affect DGF and AR rates.

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Effect of donor and recipient variables on the long-term live-donor renal allograft survival in children

Cited by 6 publications

References 24 publications

Modeling Long-Term Graft Survival With Time-Varying Covariate Effects: An Application to a Single Kidney Transplant Centre in Johannesburg, South Africa

Modeling Long-Term Graft Survival With Time-Varying Covariate Effects: An Application to a Single Kidney Transplant Centre in Johannesburg, South Africa

Good outcome of the single‐center pediatric kidney transplant program in Abu Dhabi

The Impact of Recipient Demographics on Outcomes from Living Donor Kidneys: Systematic Review and Meta-Analysis

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