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Influence of early graft function after renal transplantation and its impact on long-term graft and patient survival.

Abstract：

OBJECTIVE:To determine whether early graft function after transplantation impacted graft and patient survivals. MATERIALS AND METHODS:Between 1981 and 2008, we performed 1308 renal transplantations. Poor early graft function was defined as a Cockroft-Gault glomerular filtration rate<60 mL/min or less at 1 and 3 months posttransplant. Patients who lost their kidney or died within the first 12 months after transplantation were excluded from the study. Multivariate statistical analysis used Cox proportional hazards models. RESULTS:Of the 1308 patients 994 (78.8%) displayed poor early graft function at 1 month after transplantation (glomerular filtration rate<60 mL/min), while 268 (21.2%) showed normal function (glomerular filtration rate≥60 mL/min). The 2- and 6-year graft survival rates among the poor early graft function group were 96.8% and 85.8%, respectively, while those among the control group were 97.0% and 88.3%, respectively. The 2- and 6-year patient survival rates in the poor early graft function were 98.5% and 89.8% versus 98.9% and 96.3% in the control group. Similar results were observed at 3 months posttransplant. Controlling for patient age, donor age, HLA-AB and -DR mismatches, cold ischemia time, acute rejection episodes, cyclosporine therapy, and waiting time for transplantation, we did not observe early graft function to be a risk factor for graft survival or patient survival. Glomerular filtration rate at 2, 5, and 6 years after kidney transplantation was significantly lower in the poor early graft function than in the control group. CONCLUSION:This study suggested that the quality of early graft function had no significant effect on graft and patient survival rate, but did have a significant influence on long-term renal function.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Pita-Fernández S,Valdés-Cañedo F,Seoane-Pillado T,Lorenzo-Aguiar D,Oliver-Garcia J,Blanco-Castro N,Seijo-Bestilleiro R,Pértega-Díaz S

doi

10.1016/j.transproceed.2010.07.073

subject

Has Abstract

pub_date

2010-10-01 00:00:00

pages

2856-8

issue

8

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(10)01118-8

journal_volume

42

pub_type

杂志文章

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