2024-03-29T11:04:29Zhttps://uvadoc.uva.es/oai/requestoai:uvadoc.uva.es:10324/509392022-07-18T09:32:56Zcom_10324_1179com_10324_931com_10324_894col_10324_1306
Risk factors for graft loss and mortality after renal transplantation according to recipient age: a prospective multicentre study
Morales Cerdán, Jose Maria
Marcén Letosa, Roberto
Castillo Caba, Domingo del
Andrés Belmonte, Amado
Gonzalez Molina, Miguel
Oppenheimer Salinas, Federico
Serón Micas, Daniel
Gil Vernet, Salvador
Lampreave Gaztelu, Ildefonso
Gainza Ríos, Francisco Javier
Valdés Cañedo, Francisco Antonio
Cabello Díaz, Mercedes
Anaya Fernández-Lomana, Fernando
Escuín Sancho, Fernando
Arias Rodríguez, Manuel
Pallardó Mateu, Luis
Bustamante Bustamante, Jesús
Riñones - Trasplante
Mortalidad
Survival
Supervivencia
Riñones - Enfermedades
Background. To describe the causes of graft loss, patient death and survival figures in kidney transplant patients in Spain based on the recipient’s age. Methods. The results at 5 years of post-transplant cardiovascular disease (CVD) patients, taken from a database on CVD, were prospectively analysed, i.e. a total of 2600 transplanted patients during 2000–2002 in 14 Spanish renal transplant units, most of them receiving their organ from cadaver donors. Patients were grouped according to the recipient’s age: Group A: <40 years, Group B: 40–60 years and Group C: >60 years. The most frequent immunosuppressive regimen included tacrolimus, mycophenolate mofetil and steroids. Results. Patients were distributed as follows: 25.85% in Group A (>40 years), 50.9% in Group B (40–60 years) and 23.19% in Group C (>60). The 5-year survival for the different age groups was 97.4, 90.8 and 77.7%, respectively. Death-censored graft survival was 88, 84.2 and 79.1%, respectively, and non death-censored graft survival was 82.1, 80.3 and 64.7%, respectively. Across all age groups, CVD and infections were the most frequent cause of death. The main causes of graft loss were chronic allograft
dysfunction in patients <40 years old and death with functioning graft in the two remaining groups. In the multivariate analysis for graft survival, only elevated creatinine levels and proteinuria >1 g at 6 months post-transplantation were statistically significant in the three age groups. The patient survival multivariate analysis did not achieve a statistically significant common factor in the three age groups.
Conclusions. Five-year results show an excellent recipient survival and graft survival, especially in the youngest age group. Death with functioning graft is the leading cause of graft loss in patients >40 years. Early improvement of renal function and proteinuria together with strict control of cardiovascular
risk factors are mandatory.
2021-12-14T09:57:31Z
2021-12-14T09:57:31Z
2021-12-14T09:57:31Z
2012
info:eu-repo/semantics/article
Nephrology Dialysis Transplantation, 2012, vol. 27, supl. 4, p. 39–46
0931-0509
https://uvadoc.uva.es/handle/10324/50939
10.1093/ndt/gfs544
iv39
suppl 4
iv46
Nephrology Dialysis Transplantation
27
1460-2385
eng
https://academic.oup.com/ndt/article/27/suppl_4/iv39/1882932
info:eu-repo/semantics/openAccess
http://creativecommons.org/licenses/by-nc-nd/4.0/
© 2012 Oxford University Press
Attribution-NonCommercial-NoDerivatives 4.0 Internacional
Oxford University Press
European Renal Association