Korean J Transplant.  2022 Nov;36(Supple 1):S316. 10.4285/ATW2022.F-4549.

Risk factors for 1-year low graft function after deceased donor kidney transplantation

• Oh YJ
• Jun H
• Kim MG
• Jung CW

• KMID: 2535543
• DOI: http://doi.org/10.4285/ATW2022.F-4549

Abstract

Background
As the use of kidney grafts from extended criteria donors increases due to the shortage of donor organs, concerns about graft outcomes after kidney transplantation (KT) has been amplified. Estimated glomerular filtration rate (eGFR) is an intuitive indicator of kidney function and lower eGFR 1 year after KT is associated with early graft loss. This study aimed to investigate the risk factors for low eGFR at 1 year after deceased donor KT.
Methods
A retrospective study was performed in patients who underwent deceased donor KT at our hospital from 2009 to 2018. Graft loss within 1 year after KT were excluded. According to the Modification Of Diet In Renal Disease equation, less than 45 eGFR at 1 year after KT was defined as low eGFR. Logistic regression analysis was used to identified the risk factors for low eGFR.
Results
This study included 148 patients consisting of 112 with normal eGFR and 36 with low eGFR at 1 year after KT. The age of donors and the proportion of female were higher in the low eGFR group. Donor age older than 50 years and body mass index (BMI) above 25 kg/m 2 of the donors were significant risk factors for low eGFR (odds ratio [OR], 3.546; P=0.018 and OR, 2.747; P=0.047, respectively). Acute rejection after KT was significantly higher in the low eGFR group (20.5% vs. 63.9%), which was a strong risk factor for low eGFR (OR, 7.293; P<0.001). Cytomegalovirus infection within 1 year after KT was significantly higher in the low eGFR group (18.8% vs. 47.2%), which was a significant risk factor for low eGFR (OR, 3.237; P=0.018).
Conclusions
Aged donors or higher BMI were donor factors predicting the low eGFR at 1 year after KT. Cytomegalovirus infec-tion and, not surprisingly, acute rejection were risk factors affecting low eGFR at the same period of time.