Recipient Criteria Predictive of Graft Failure in Kidney Transplantation.

Abstract

Several classifications systems have been developed to predict outcomes of kidney transplantation based on donor variables. This study aims to identify kidney transplant recipient variables that would predict graft outcome irrespective of donor characteristics. All U.S. kidney transplant recipients between October 25,1999 and January 1, 2007 were reviewed. Cox proportional hazards regression was used to model time until graft failure. Death-censored and nondeath-censored graft survival models were generated for recipients of live and deceased donor organs. Recipient age, gender, body mass index (BMI), presence of cardiac risk factors, peripheral vascular disease, pulmonary disease, diabetes, cerebrovascular disease, history of malignancy, hepatitis B core antibody, hepatitis C infection, dialysis status, panel-reactive antibodies (PRA), geographic region, educational level, and prior kidney transplant were evaluated in all kidney transplant recipients. Among the 88,284 adult transplant recipients the following groups had increased risk of graft failure: younger and older recipients, increasing PRA (hazard ratio [HR],1.03-1.06], increasing BMI (HR, 1.04-1.62), previous kidney transplant (HR, 1.17-1.26), dialysis at the time of transplantation (HR, 1.39-1.51), hepatitis C infection (HR, 1.41-1.63), and educational level (HR, 1.05-1.42). Predictive criteria based on recipient characteristics could guide organ allocation, risk stratification, and patient expectations in planning kidney transplantation.

• Authors: Ernesto P Molmenti, Asha Alex, Lisa Rosen, Mohini Alexander, Jeffrey Nicastro, Jingyan Yang, Eric Siskind, Leesha Alex, Emil Sameyah, Madhu Bhaskaran, Nicole Ali, Amit Basu, Mala Sachdeva, Stergiani Agorastos, Prejith Rajendran, Prathik Krishnan, Poornima Ramadas, Leo Amodu, Joaquin Cagliani, Sameer Rehman, Adam Kressel, Christine B Sethna, Georgios C Sotiropoulos, Arnold Radtke, George Sgourakis, Richard Schwarz, Steven Fishbane, Alessandro Bellucci, Gene Coppa, Horacio Rilo, Christine L Molmenti
• Journal: The International journal of angiology : official publication of the International College of Angiology, Inc (Int J Angiol) Vol. 25 Issue 1 Pg. 29-38 (Mar 2016) ISSN: 1061-1711 [Print] United States
• PMID: 26900309 (Publication Type: Journal Article)