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Impact of Pre-existing Comorbidities on Long-term Outcomes in Kidney Transplant Recipients

A Kleinsteuber1, F Halleck1, D Khadzhynov1

  • 1Division of Nephrology and Internal Intensive Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany.

Transplantation Proceedings
|December 23, 2018
PubMed

Insights

Pre-transplant comorbidities like coronary artery disease significantly impact kidney transplant patient survival and graft loss. Understanding these risks improves patient evaluation and post-transplant care.

Area of Science:

  • Nephrology
  • Transplantation Medicine
  • Cardiovascular Medicine

Background:

  • Patient outcomes in end-stage renal disease are heavily influenced by comorbidities.
  • Limited data exists on the long-term effects of pre-transplant comorbidities on kidney transplant recipients.

Purpose of the Study:

  • To investigate the prevalence and impact of key pre-transplant comorbidities on long-term outcomes in kidney transplant recipients.
  • To identify independent risk factors for patient survival and graft loss after kidney transplantation.

Main Methods:

  • A retrospective analysis of 839 deceased donor kidney transplant recipients (KTRs) transplanted between 1999 and 2014.
  • Detailed examination of the prevalence and effects of relevant comorbidities.

Main Results:

  • Coronary artery disease (CAD), diabetes mellitus (DM), peripheral arterial disease (PAD), and chronic heart failure (CHF) were prevalent comorbidities.
  • Pre-existing CAD, DM, PAD, and CHF were associated with inferior patient survival.
  • CAD was the most hazardous independent risk factor for premature death (HR 1.70). CHF and PAD independently predicted graft loss (HR 2.20 and 1.80, respectively).
  • Diabetes was linked to increased T-cell and antibody-mediated rejections.

Conclusions:

  • Quantifying pre-transplant comorbidity impact aids in evaluating transplant candidates.
  • Findings can guide post-transplant follow-up strategies.
  • Results may refine prediction algorithms and organ allocation systems for kidney transplantation.
Abstract

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