Role of Donor Age and Acute Rejection Episodes on Long-Term Graft Survival in Cadaveric Kidney Transplantations

Emiroğlu, R; Yağmurdur, Mahmut Can; Karakayalı, Feza; Haberal, Cevahir; Ozcelik, Umit; Çolak, Turan; Haberal, Mehmet

doi:10.1016/j.transproceed.2005.08.038

Cited by 14 publications

(10 citation statements)

References 11 publications

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“…The 10-year graft SR for patients who have a previous episode of AR is 45%, reduced significantly compared to the patients with no AR (19). AR has a significant adverse impact on deceased donor allograft survival (18)(19)(20)(21), especially occurring after 3 months (20). Our patients have experienced less acute rejection episodes (21.8%), most likely because of their low immunologic risk.…”

Section: Discussionmentioning

confidence: 72%

“…Acute rejection is seen in 43.3-50.8% of DDKTx patients (18)(19)(20)(21). The 10-year graft SR for patients who have a previous episode of AR is 45%, reduced significantly compared to the patients with no AR (19).…”

Section: Discussionmentioning

confidence: 99%

“…The overall incidence of arterial thrombosis ranges between 0.4-3.0% and venous thrombosis between 0.4-3.4% in DDKTx patients (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25). Deceased donor is a significant risk factor for developing renal allograft thrombosis along with donor age <6 or >60 years, recipient age <5-6 or >50 years, hemodynamic instability, peritoneal dialysis, recipient vessel atherosclerosis, diabetic nephropathy, a history of thrombosis, and DGF (24)(25)(26).…”

Section: Discussionmentioning

confidence: 99%

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Factors Affecting Allograft and Patient Survival in Deceased Donor Kidney Transplantation: A Single Center Experience in Turkey

Kumru¹,

Çelebi²,

Aktürk³

et al. 2016

Turk Neph Dial Transpl

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OBJECTIVE:Renal transplantation is the treatment of choice in end-stage renal diseases. Long-term allograft function has remained steady in deceased donor kidney transplantation (DDKTx) during recent decades. In this study, we evaluated DDKTx outcomes at our hospital. MATERIAL and METHODS:72 cadaveric transplant patients who were grafted between January 2002 and October 2013 at our center were analysed retrospectively. Recipients and donors' demographic properties, immunologic and nonimmunologic characteristics, allograft function and emerging complications were examined. Factors associated with graft and patient loss were investigated. RESULTS:Mean follow-up period was 60±38 months. Mean recipient age was 42±11 years, of which 51.4% was male. Dialysis vintage was 83±59 months, while mean cold ischemia time was 12±3 hours. One and five year graft and patient survival rates were 94.4%, 92.3% and 97.2%, 89.9% respectively. High serum creatinine value at discharge (p=0.003) and early surgical complications (p=0.041) were independent risk factors associated with poor graft survival. Having a recipient age ≥46 years (p=0.037) and cardiovascular disease (p=0.017) caused patient loss. Cardiovascular disease was independently associated with patient loss (HR=6.45[1.08-38.70], p=0.041). CONCLUSION:In this study, it was demonstrated that creatinine value at discharge and early surgical complications were associated with allograft loss, while cardiovascular disease was associated with patient loss in DDKTx. BULGULAR: Ortalama takip süresi 60±38 aydır. Alıcıların ortalama yaşı 42±11 yıl, %51.4'ü erkektir. Nakil öncesi ortalama diyaliz süresi 83±59 aydır. Ortalama soğuk iskemi zamanı 12±3 saattir. Bir ve beş yıllık graft sağkalımı sırasıyla %94.4, %92.3; hasta sağkalımı %97.2, %89.9'dur. Hastaneden çıkış kreatinini yüksekliği (p=0.003) ve erken cerrahi komplikasyonların gelişimi (p=0.041) graft sağkalımını olumsuz etkileyen bağımsız risk faktörleridir. Alıcı yaşı≥46 olması (p=0.037) ve kardiyovasküler hastalık gelişimi (p=0.017) hasta kaybını artırmaktadır. Kardiyovasküler hastalık gelişimi hasta kaybı için bağımsız risk faktörüdür (HR=6,], p=0.041).SONUÇ: Çalışmada, kadaverik böbrek nakillerinde hastaneden çıkış kreatinini yüksekliği ve erken cerrahi komplikasyonların gelişiminin allograft kaybını, kardiyovasküler hastalık gelişminin hasta kaybını artırdığı gösterilmiştir.

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Factors Affecting Allograft and Patient Survival in Deceased Donor Kidney Transplantation: A Single Center Experience in Turkey

Kumru¹,

Çelebi²,

Aktürk³

et al. 2016

Turk Neph Dial Transpl

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“…Moreover, after an acute rejection, the development of a chronic rejection becomes more likely. In particular, early acute rejection, frequent acute rejection episodes, and refractory acute rejection can drastically affect long-term survival of a renal graft [7, 13, 14]. The data we presented in this study show that the incidence of acute rejection in the long-term survival patient group was significantly lower than that of the control group and a predictor of graft survival.…”

Section: Discussionmentioning

confidence: 80%

Over Ten-Year Kidney Graft Survival Determinants

Guedes

Malheiro

Fonseca

et al. 2012

International Journal of Nephrology

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Kidney graft survival has been mainly evaluated using an up to 10-year threshold. Instead, in this study our aim was to evaluate predictive variables that impact long-term kidney graft survival (≥10 years). We enrolled 892 patients in our analysis: 638 patients with functioning graft at 10 years PT and 254 patients with graft failure at 10 years PT (considering patient death with a functioning graft <10 years PT as graft failure). Between groups comparisons were done using Mann-Whitney and chi-square test. To determine independent predictive variables for long-term graft survival a multivariate-adjusted logistic regression was performed. Significant predictors of long term graft survival were lower 12-month PT creatinine (OR = 0.26, P < 0.001), lower donor age (OR = 0.98, P = 0.004), shorter time on dialysis (OR = 0.93, P = 0.044), recipient positive CMV IgG (OR = 1.59, P = 0.040), absence of AR episodes (OR = 1.57, P = 0.047), 0 to 1 (versus 2) HLA-B mismatch (OR = 1.80, P = 0.004), and recipients male gender (OR = 1.84, P = 0.005). Our results show that an early KT, younger donor age, and an optimal first year graft function are of paramount importance for long-term graft survival. Measures that address these issues (careful donor selection, preemptive KT, and effective immunosuppressive protocols) are still warranted.

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“…Acute rejection is the most important immunological risk factor to chronic allograft injury . While the risk of acute rejection is highest in the early post‐transplant phase, the occurrence of late acute rejections (LAR) is associated with a less favourable allograft survival and chronic transplant glomerulopathy . The literature to date on LAR is based on experience from the United States, European countries and Australia.…”

mentioning

confidence: 99%

Risk factors and prognosis of late acute rejection in Chinese kidney transplant recipients

et al. 2017

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Late acute rejection is uncommon in Chinese kidney transplant recipients but is associated with reduced allograft survival. Risk factors include acute rejection in the first post-transplant year and trough CsA level below 80 μg/L in patients on CsA-based maintenance immunosuppression. Minimization of immunosuppression in apparently stable kidney transplant recipients must be exercised with caution.

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Role of Donor Age and Acute Rejection Episodes on Long-Term Graft Survival in Cadaveric Kidney Transplantations

Cited by 14 publications

References 11 publications

Factors Affecting Allograft and Patient Survival in Deceased Donor Kidney Transplantation: A Single Center Experience in Turkey

Factors Affecting Allograft and Patient Survival in Deceased Donor Kidney Transplantation: A Single Center Experience in Turkey

Over Ten-Year Kidney Graft Survival Determinants

Risk factors and prognosis of late acute rejection in Chinese kidney transplant recipients

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Role of Donor Age and Acute Rejection Episodes on Long-Term Graft Survival in Cadaveric Kidney Transplantations

Cited by 14 publications

References 11 publications

Factors Affecting Allograft and Patient Survival in Deceased Donor ￼Kidney Transplantation: A Single Center Experience in Turkey

Factors Affecting Allograft and Patient Survival in Deceased Donor ￼Kidney Transplantation: A Single Center Experience in Turkey

Over Ten-Year Kidney Graft Survival Determinants

Risk factors and prognosis of late acute rejection in Chinese kidney transplant recipients

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Product

Resources

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Factors Affecting Allograft and Patient Survival in Deceased Donor Kidney Transplantation: A Single Center Experience in Turkey

Factors Affecting Allograft and Patient Survival in Deceased Donor Kidney Transplantation: A Single Center Experience in Turkey