J Korean Soc Transplant.  2012 Sep;26(3):178-187. 10.4285/jkstn.2012.26.3.178.

Evaluation of Independent Risk Factors Affecting Renal Allograft Survival by Transplant Era

• Kim YS
• Kim SI
• Kim MS
• Huh KH
• Ju MK
• Joo DJ
• Kim HJ
• Jeon KO
• Kim HJ
• Park K

• KMID: 2003533
• DOI: http://doi.org/10.4285/jkstn.2012.26.3.178

Abstract

BACKGROUND
Using long-term (more than 30 years) data from a single center, this retrospective study evaluated changes of independent risk factors affecting renal allograft survival by transplant era.
METHODS
Of 3,000 cases of kidney transplantation, 2,708 (90.3%), including their follow-up observations, were reviewed. Transplant era was classified according to immunosuppressive regimens as either early group (transplant serial No. 1~1,500) or recent group (transplant serial No. 1,501~3,000).
RESULTS
There was a significant difference observed in pre-transplant clinical manifestations between the early and recent groups. The number of elderly recipients and donors, number of deceased donors, and cases related to pre-transplant diabetes, pre-emptive transplantation, and retransplantation were differed relative to transplant era. The short- and long-term graft survival rate of the recent group improved significantly, and the effect of human leukocyte antigen mismatching and living donor type disappeared in the recent group. Moreover, pre-emptive transplantation and retransplantation were effective only in the recent group. However, non-immunological factors such as elderly recipients and donors, and immunologic factors such as episodes of acute rejection and types of immunosuppressive regimen were persistent independent risk factors affecting graft survival rate.
CONCLUSIONS
According to the retrospective survival analysis of a large number of recipients in a single center, risk factors for kidney transplant patients differed by transplant era. However, the independent risk factors associated with elderly recipients and donors (non-immunologic), and episodes of acute rejection, and types of immunosuppressive regimen (immunologic) persisted regardless of transplant era.

Keyword

Risk factors; Kidney transplantation; Graft survival

MeSH Terms

Aged
Follow-Up Studies
Graft Survival
Humans
Immunologic Factors
Kidney
Kidney Transplantation
Leukocytes
Living Donors
Rejection (Psychology)
Retrospective Studies
Risk Factors
Tissue Donors
Transplantation, Homologous
Transplants
Immunologic Factors