Recipient Comorbidity and Survival Outcomes After Kidney Transplantation: A UK-wide Prospective Cohort Study

Wu, Diana A.; Robb, Matthew; Forsythe, John; Bradley, Clare; Cairns, John; Draper, Heather; Dudley, Christopher; Rj, Johnson; Metcalfe, Wendy; Ravanan, Rommel; Roderick, Paul; Tomson, Charles; Watson, Christopher J.; Bradley, J. Andrew; Oniscu, Gabriel C.

doi:10.1097/tp.0000000000002931

Cited by 39 publications

(23 citation statements)

References 40 publications

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“…In kidney transplant patients, CVD-related mortality is 2 times higher than the general population since non-classical risk factors such as proteinuria and decreased Glomerular filtration rate (GFR) is more common in addition to DM, HT, HL, which are the classical risk factors for CVD (3). Wu et al (12) found a 2-year patient survival rate of 94.7%, and HF and DM were found as independent risk factors for transplant failure (considered as graft loss and/or patient death). Fuggle et al (13) showed in their reports that come from the United Kingdom (UK), 1st-year survival after LKDT was found to be 99%.…”

Section: Discussionmentioning

confidence: 99%

First-year mortality in living donor kidney transplantation: twelve-year experience from a single center

Merhametsiz

Demir

Sevmiş

et al. 2021

Journal of Health Sciences and Medicine

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Objective:The mortality was seen in the early period after kidney transplantation is one of the most undesirable consequences of kidney transplant treatment. This study was aimed to evaluate the factors affecting the 1st-year mortality in patients who underwent living donor kidney transplantation (LDKT) in our center. Material and Method: Adult patients who underwent LDKT developed mortality within the 1st-year in our center between 2008 and 2020. Mortality group and the control group are compared according to donor and recipient characteristics. The risk factors that have an adjusted effect on 1st-year mortality after kidney transplantation were evaluated by cox regression survival analysis. Results: Total mortality incidence was 8.35% and the 1st-year mortality incidence was 1.67%. Median dialysis duration (13 months vs. 3 months) was longer in the mortality-group, p=0.022. Cardiovascular disease (CVD) was more common in the mortality-group (50% vs. 31.1%), p=0.037. Median HLA mismatch numbers was higher in the mortality-group (4 vs. 3), p=0.027. According to Model 1, in terms of 1st-year mortality, each 1 year increment in recipient's age increases the mortality by 1.034 times, and dialysis treatment increases the mortality 2.5 times. According to Model 2, in terms of 1st-year mortality, each 1 year increment in recipient's age increase the mortality by 1.039 times, dialysis treatment increases the mortality 2.8 times and each 1 mismatch increase in human leukocyte antigen (HLA) mismatch numbers increases the mortality by 1.3 times. Receiver operating characteristic analysis showed that the moderate predictive power for recipient age was area under the curve (AUC) 0.734 (95% CI 0.623-0.844, p<0.001) and the weak level predictive power AUC was for HLA mismatch 0.639 (95% CI 0.519-0.759, p=0.030) in terms of 1st-year mortality. Conclussion: This study presented that the 1st-year mortality results of our organ transplant center are similar to the national and international literature. We determined recipient age, dialysis treatment and HLA mismatch numbers as independent risk factors affecting 1st-year mortality after LDKT.

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Section: Discussionmentioning

confidence: 99%

First-year mortality in living donor kidney transplantation: twelve-year experience from a single center

Merhametsiz

Demir

Sevmiş

et al. 2021

Journal of Health Sciences and Medicine

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“…� Frailty: Harhay et al 30 This review of the OPTN data revealed that DDKT recipients with �10% pretransplant weight loss are at increased risk for longer hospital length of stay, higher all-cause graft loss, and higher mortality. � Risk stratification: Wu et al 40 In this prospective cohort study of 2100 KT recipients, peripheral vascular disease, obesity, heart failure, cerebrovascular disease, and chronic liver disease were risk factors for graft loss and mortality in DDKT recipients. For LDKT recipients, heart failure and diabetes were risk factors for poorer transplant survival.…”

Section: Kidney Transplantation (Kt)mentioning

confidence: 99%

“…Wu et al performed a large prospective cohort study of 2100 DDKT and LDKT recipients and analyzed data on 15 comorbidities at the time of transplantation and their relationships with 2-year graft and patient survival. 40 They found that for DDKT recipients, peripheral vascular disease ( 40 Abrol et al sought to identify preoperative factors predicting KT recipients' early admission (within 30 days) to the intensive care unit (ICU). Of the 1527 eligible patients, 305 (20%) required early ICU admission.…”

Section: Other Comorbidities As Risk Factorsmentioning

confidence: 99%

Abdominal Organ Transplantation: Noteworthy Literature in 2019

Romano

Vasisko

Zerillo

et al. 2020

Semin Cardiothorac Vasc Anesth

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In the year 2019, we identified and screened over 400 peer-reviewed publications on pancreatic transplantation, over 200 on intestinal transplantation, and over 1900 on kidney transplantation. The liver transplantation section focuses on and features selected articles among 70 clinical trials published in 2019. This review highlights noteworthy literature pertinent to anesthesiologists and critical care physicians caring for patients undergoing abdominal organ transplantation. We explore a broad range of topics, including risks for and prediction of perioperative complications, updated indications for transplantation, recommendations on perioperative management, including Enhanced Recovery After Surgery programs, and topics relevant to optimization of patient and graft outcomes and survival.

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“…However, its identification in transplant patients is essential because of the known adverse relationship between peripheral vascular disease and transplant outcomes. Lower extremity peripheral arterial disease is associated with lower patient survival after renal transplantation, and moderate-to-severe lower extremity arterial calcification is associated with increased waitlist mortality and lower patient and graft survival after transplantation [ 4 , 8 , 9 ]. Peripheral vascular disease is also one of the core parameters utilized in preoperative risk stratification indexes for mortality prediction in transplant candidates [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Effectiveness of Screening for Iliac Arterial Calcification in Kidney Transplant Candidates

et al. 2020

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Recipient Comorbidity and Survival Outcomes After Kidney Transplantation: A UK-wide Prospective Cohort Study

Cited by 39 publications

References 40 publications

First-year mortality in living donor kidney transplantation: twelve-year experience from a single center

First-year mortality in living donor kidney transplantation: twelve-year experience from a single center

Abdominal Organ Transplantation: Noteworthy Literature in 2019

Evaluation of the Effectiveness of Screening for Iliac Arterial Calcification in Kidney Transplant Candidates

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