Korean J Transplant.  2020 Dec;34(4):244-248. 10.4285/kjt.20.0053.

Serum creatinine level at 1-month posttransplant can independently predict long-term graft survival and functional status

• Koh SM
• Ju MK
• Huh KH
• Kim YS
• Kim MS

• KMID: 2510262
• DOI: http://doi.org/10.4285/kjt.20.0053

Abstract

Background
After the year 2000, kidney transplants with high immunologic risk and deceased donors increased rapidly in Korea. At the same time, the medical community developed special pretransplant and early posttransplantation management protocols. Our team evaluated the effect of early graft stabilization on long-term graft survival and functional status using databases from a high-volume kidney transplantation center.
Methods
We included 1,895 kidney transplant patients from a total of 1,976 performed between 2005 and 2018. Early graft failure within 1 month (n=9), loss to follow-up (n=2), pediatric recipient or donor (n=37), and combined organ transplantation (n=33) cases were excluded. We grouped the cases at 1-month posttransplantation by serum creati-nine quantiles (1.0 mg%, 1.23 mg%, and 1.52 mg%).
Results
After an average of 95 months of follow-up (maximum 189 months), the high-se- rum creatinine group (4th quantile) showed significantly poorer graft survival than other groups (1st to 3rd quantile) (P<0.05). In multiple Cox regression analysis, a high serum creatinine level (4th quantile) at 1-month posttransplant is an independent risk factor for graft failure with a hazard ratio of 1.799 (P=0.013). The quantile group by serum cre-atinine shows a persistent, significant difference of functional graft status (glomerular filtration rate by Modification of Diet in Renal Disease method) among quantile groups beyond ten years posttransplant.
Conclusions
Serum creatinine level at 1-month posttransplant is a strong independent predictor of graft survival and functional graft status beyond ten years posttransplant.

Keyword

Creatinine; Kidney transplant; Graft survival

Figure

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  Fig. 1 Mean glomerular filtration rate (GFR) of functioning graft by quantile group of serum creatinine quantile at 1-month posttransplant. Q, quartile. a)P<0.05 vs. each other.

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  Fig. 2 Graft survival rate by quantile group of serum creatinine quantile at 1-month posttransplant. Q, quartile. a)P<0.05 vs. others.

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