Graft and patient survival in kidney transplantation: A single-center experience

Chang-Hsu Chen ； Yuan-Chuan Kuo ； Tsai-Kun Wu ； Hung-Ping Chen ； Tien-Yu Tseng ； Mei-An Pai ； Shiaw-Wen Chien ； Paik-Seong Lim

《童綜合醫學雜誌》 16卷2期 (2022/12) Pp. 47-53

https://doi.org/10.4103/ETMJ.TMJ-109030

摘要

Background: Patients with end-stage renal disease need renal replacement therapy, including hemodialysis, peritoneal dialysis, and kidney transplant (KT), to live a relatively normal life. Compared with other dialysis modalities, KT remains the choice for better survival. Objectives: This study aimed to report the KT outcomes at our center and investigate risk factors for graft and patient survival. Methods: This is a retrospective chart review of 72 KT recipients cared for at our center between July 1, 2004, and June 30, 2017. Delayed graft function (DGF) was defined as the need for dialysis within 1 week after KT. The primary outcome is death after KT. The secondary outcome is graft failure, which is defined as a return to dialysis while the patient is alive. Patient death with functional graft was censored during the survival analysis. Results: Among the patients, 17 KT recipients had primary diabetic nephropathy (23.6%) with a mean age of 47.4 ± 11.8 years. Furthermore, 13 patients returned to dialysis and 12 died during the study period, with malignancy being the leading cause of death (n = 4). The 1-, 3-, and 5-year graft survival rates were 94.3%, 90.4%, and 85.4%, respectively. The 1, 3-, and 5-year patient survival rates were 97.1%, 92.1%, and 85.7%, respectively. A total of 24 patients (33%) encountered DGF after KT. Patients with DGF had significantly poorer graft survival than those without DGF (P = 0.002 by log-rank test). Cox-proportional hazard analysis revealed that only DGF increased the risk of graft failure (hazard ratio (HR) = 6.52, 95% confidence interval (CI): 1.4629.2), and age predicted patient survival (HR = 1.09, 95% CI: 1.021.17). Conclusion: This study showed that patients with DGF had significantly poor graft survival. Patient's age was the only prognostic factor for patient survival in our cohort.

關鍵字

Delayed graft function ； graft survival ； kidney transplantation ； patient survival