Death with a functioning graft in kidney transplant recipients

Area of Science:

• Nephrology
• Transplantation Immunology
• Public Health

Background:

• Trends in deceased donor kidney transplant outcomes have evolved.
• Understanding factors contributing to graft loss and patient mortality is crucial for improving transplant success.

Purpose of the Study:

• To analyze trends in deaths with a functioning graft (DWF) in kidney transplant recipients.
• To identify risk factors associated with DWF in both deceased and living donor kidney transplants.

Main Methods:

• Retrospective analysis of kidney transplant recipient data.
• Multivariable analysis to identify significant risk factors for DWF.

Main Results:

• DWF within one year increased by 1% (1993-1995), while DWF between 2-5 years decreased since 1992.
• Infections and hemorrhage increased as causes of early DWF; cardiovascular disease decreased as a cause of later DWF.
• Diabetes, older recipient age, donor age (>45), CMV status, and PRA were significant risk factors for DWF in deceased donor transplants.

Conclusions:

• DWF trends are complex, with increasing early mortality causes and decreasing later mortality causes.
• Recipient and donor factors significantly influence DWF, highlighting the need for personalized risk assessment and management strategies.
• Specific immunosuppression regimens and delayed graft function also impact DWF outcomes.