Patient's Death with a Functioning Graft is still the Most Common Cause of Kidney Transplant Loss

    loading  Checking for direct PDF access through Ovid

Abstract

Introduction and Aims

Kidney transplantation is the best and the most cost-effective modality of renal replacement therapy for patients with end stage chronic kidney disease. The mortality rate is higher in these patients than in general population, mainly caused by cardiovascular disease (CV).

Introduction and Aims

Death with a functioning graft (DWF) has increased over the decade, mitigating improvements in overall graft survival, probably due to older patient population with greater comorbidities who continue to have chronic immunosuppressive treatment. The ratio of mortality either by infectious or tumoral diseases has also highly increased.

Introduction and Aims

The causes of kidney allograft loss remain unclear. We investigated these causes in 1446 kidney transplant recipients.

Introduction and Aims

Our objective was to identify the main causes of mortality of renal transplant patients in our hospital. We described the global frequency of death with function (DWF), as well as the main causes of mortality in our patients.

Methods

It is a descriptive and transversal study in 1446 kidney transplant recipients followed-up in outpatient clinic, where frequency of death and most common causes were analyzed.

Results

During the follow-up, death with function (DWF) was the single most commonly observed cause of graft loss, 244 grafts,16,9% of all transplants.

Results

The frequency of death before discharge was 1.5% (N=22), before one year posttransplant 3.3% (N=48) and global mortality(16,9%)%)(N=244).

Results

The first cause of death was Cardiovascular(36,2%), followed by infections (22,3%) and malignancies(17,5%).

Results

There were no differences in the causes of death that occurred during the first year and more than 1 year posttransplant.

Results

63,5% of the patients had at least one hospitalization after trasplantation, which 9,7% did at ICU.

Results

The most frequent maintenance for immunosuppressive regimen was tacrolimus+micofenolate (MMF)+prednisone (24,9%)

Results

The remaining functioning grafts were lost due to a variety of causes, including glomerular diseases (recurrent, transplant glomerulopathy, nonrecurrent) interstitial fibrosis/ tubular atrophy (IF/TA) and acute rejection (either celular or antibody-mediated).

Conclusion

Patient´s death with a functioning graft (DWF) has increased over the decade, mitigating improvements in overall graft survival, probably due to older patient population with greater comorbidities and it is still the most common cause of graft loss. Being the first cause of death cardiovascular, followed by infections, malignancies and others.

Related Topics

    loading  Loading Related Articles