1. Risk factors for graft loss and mortality after renal transplantation according to recipient age: a prospective multicentre study.
- Author
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Morales JM, Marcén R, del Castillo D, Andres A, Gonzalez-Molina M, Oppenheimer F, Serón D, Gil-Vernet S, Lampreave I, Gainza FJ, Valdés F, Cabello M, Anaya F, Escuin F, Arias M, Pallardó L, and Bustamante J
- Subjects
- Adult, Age Distribution, Female, Humans, Male, Middle Aged, Prospective Studies, Risk Factors, Survival Rate, Time Factors, Graft Rejection epidemiology, Kidney Transplantation mortality
- Abstract
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.
- Published
- 2012
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