Long-term allograft survival after kidney transplantation.

Abstract:

BACKGROUND:Technical and medical advances over the past few years have produced an important increase in the functionality of renal allografts. The aim of this study was to identify the factors associated with allograft survival 15 years after transplantation in our series. METHODS:A retrospective study of kidney transplantations was carried out at Reina Sofia Hospital in Cordoba from February 1979 to December 1997, with follow-up through June 2012. A subanalysis of the series was undertaken, and Kaplan-Meier analysis and Cox proportional hazards model regression used to achieve the main objective of the study. RESULTS:A total of 487 renal allografts with a mean follow-up of 114 months were studied, of which 37% (n = 180) survived for >15 years. Of the 180 patients, the main causes of graft failure were chronic allograft nephropathy in 29 (66%) and patient death in 13 (29.5%). Multivariate analysis identified the number of HLA mismatches (hazard ratio [HR] 1.25, 95% CI 1.01-1.56), panel reactive antibodies (HR 2.61, 95% CI 1.28-5.26), and delayed graft function (HR 11.25, 95% CI 1.33-95.28) as being significantly associated with graft loss after 15 years. CONCLUSIONS:The high immunologic risk of the patients was independently associated with graft loss. Delayed graft function was the most important factor in the speed of graft failure beyond 15 years.

journal_name

Transplant Proc

authors

Gómez EG,Hernández JP,López FJ,Garcia JR,Montemayor VG,Curado FA,Vallejo ML,López JC,Cabello MD,Aljama P,Tapia MJ

doi

10.1016/j.transproceed.2013.09.015

subject

Has Abstract

pub_date

2013-01-01 00:00:00

pages

3599-602

issue

10

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(13)00926-3

journal_volume

45

pub_type

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