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Int J Angiol 2016; 25(01): 029-038
DOI: 10.1055/s-0035-1563605
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Recipient Criteria Predictive of Graft Failure in Kidney Transplantation

Ernesto P. Molmenti
1   Department of Surgery, Hofstra North Shore-LIJ School of Medicine, New York
2   Department of Medicine, Hofstra North Shore-LIJ School of Medicine, New York
,
Asha Alex
1   Department of Surgery, Hofstra North Shore-LIJ School of Medicine, New York
,
Lisa Rosen
3   The Feinstein Institute for Medical Research, Hofstra North Shore-LIJ School of Medicine, New York
,
Mohini Alexander
2   Department of Medicine, Hofstra North Shore-LIJ School of Medicine, New York
,
Jeffrey Nicastro
1   Department of Surgery, Hofstra North Shore-LIJ School of Medicine, New York
,
Jingyan Yang
4   Mailman School of Public Health, Columbia University, New York
,
Eric Siskind
1   Department of Surgery, Hofstra North Shore-LIJ School of Medicine, New York
,
Leesha Alex
1   Department of Surgery, Hofstra North Shore-LIJ School of Medicine, New York
,
Emil Sameyah
3   The Feinstein Institute for Medical Research, Hofstra North Shore-LIJ School of Medicine, New York
,
Madhu Bhaskaran
2   Department of Medicine, Hofstra North Shore-LIJ School of Medicine, New York
,
Nicole Ali
2   Department of Medicine, Hofstra North Shore-LIJ School of Medicine, New York
,
Amit Basu
1   Department of Surgery, Hofstra North Shore-LIJ School of Medicine, New York
,
Mala Sachdeva
2   Department of Medicine, Hofstra North Shore-LIJ School of Medicine, New York
,
Stergiani Agorastos
1   Department of Surgery, Hofstra North Shore-LIJ School of Medicine, New York
,
Prejith Rajendran
1   Department of Surgery, Hofstra North Shore-LIJ School of Medicine, New York
,
Prathik Krishnan
1   Department of Surgery, Hofstra North Shore-LIJ School of Medicine, New York
,
Poornima Ramadas
1   Department of Surgery, Hofstra North Shore-LIJ School of Medicine, New York
,
Leo Amodu
1   Department of Surgery, Hofstra North Shore-LIJ School of Medicine, New York
,
Joaquin Cagliani
1   Department of Surgery, Hofstra North Shore-LIJ School of Medicine, New York
,
Sameer Rehman
1   Department of Surgery, Hofstra North Shore-LIJ School of Medicine, New York
,
Adam Kressel
1   Department of Surgery, Hofstra North Shore-LIJ School of Medicine, New York
,
Christine B. Sethna
5   Department of Pediatrics, Hofstra North Shore-LIJ School of Medicine, New York
,
Georgios C. Sotiropoulos
6   Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany
,
Arnold Radtke
7   Department of General and Visceral Surgery, University Hospital Muenster, Albert-Schweitzer-Campus, Muenster, Germany
,
George Sgourakis
8   Department of General Surgery, Red Cross Hospital, Athens, Greece
,
Richard Schwarz
2   Department of Medicine, Hofstra North Shore-LIJ School of Medicine, New York
,
Steven Fishbane
2   Department of Medicine, Hofstra North Shore-LIJ School of Medicine, New York
,
Alessandro Bellucci
2   Department of Medicine, Hofstra North Shore-LIJ School of Medicine, New York
,
Gene Coppa
1   Department of Surgery, Hofstra North Shore-LIJ School of Medicine, New York
,
Horacio Rilo
1   Department of Surgery, Hofstra North Shore-LIJ School of Medicine, New York
,
Christine L. Molmenti
4   Mailman School of Public Health, Columbia University, New York
› Author Affiliations
Further Information

Publication History

Publication Date:
15 September 2015 (online)

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Abstract

Several classifications systems have been developed to predict outcomes of kidney transplantation based on donor variables.

This study aims to identify kidney transplant recipient variables that would predict graft outcome irrespective of donor characteristics.

All U.S. kidney transplant recipients between October 25,1999 and January 1, 2007 were reviewed. Cox proportional hazards regression was used to model time until graft failure. Death-censored and nondeath-censored graft survival models were generated for recipients of live and deceased donor organs. Recipient age, gender, body mass index (BMI), presence of cardiac risk factors, peripheral vascular disease, pulmonary disease, diabetes, cerebrovascular disease, history of malignancy, hepatitis B core antibody, hepatitis C infection, dialysis status, panel-reactive antibodies (PRA), geographic region, educational level, and prior kidney transplant were evaluated in all kidney transplant recipients.

Among the 88,284 adult transplant recipients the following groups had increased risk of graft failure: younger and older recipients, increasing PRA (hazard ratio [HR],1.03–1.06], increasing BMI (HR, 1.04–1.62), previous kidney transplant (HR, 1.17–1.26), dialysis at the time of transplantation (HR, 1.39–1.51), hepatitis C infection (HR, 1.41–1.63), and educational level (HR, 1.05–1.42).

Predictive criteria based on recipient characteristics could guide organ allocation, risk stratification, and patient expectations in planning kidney transplantation.

Keywords

kidney transplant recipients - outcomes predictors - graft failure - comorbidities - patient education - geographic disparities
 

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