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Nephrol Dial Transplant. 2012 Dec;27 Suppl 4:iv39-46. doi: 10.1093/ndt/gfs544.

Risk factors for graft loss and mortality after renal transplantation according to recipient age: a prospective multicentre study.

Author information

1
Department of Nephrology, Hospital 12 de Octubre, Madrid, Spain. jmorales@h12o.es

Abstract

BACKGROUND:

To describe the causes of graft loss, patient death and survival figures in kidney transplant patients in Spain based on the recipient's age.

METHODS:

The results at 5 years of post-transplant cardiovascular disease (CVD) patients, taken from a database on CVD, were prospectively analysed, i.e. a total of 2600 transplanted patients during 2000-2002 in 14 Spanish renal transplant units, most of them receiving their organ from cadaver donors. Patients were grouped according to the recipient's age: Group A: <40 years, Group B: 40-60 years and Group C: >60 years. The most frequent immunosuppressive regimen included tacrolimus, mycophenolate mofetil and steroids.

RESULTS:

Patients were distributed as follows: 25.85% in Group A (>40 years), 50.9% in Group B (40-60 years) and 23.19% in Group C (>60). The 5-year survival for the different age groups was 97.4, 90.8 and 77.7%, respectively. Death-censored graft survival was 88, 84.2 and 79.1%, respectively, and non death-censored graft survival was 82.1, 80.3 and 64.7%, respectively. Across all age groups, CVD and infections were the most frequent cause of death. The main causes of graft loss were chronic allograft dysfunction in patients <40 years old and death with functioning graft in the two remaining groups. In the multivariate analysis for graft survival, only elevated creatinine levels and proteinuria >1 g at 6 months post-transplantation were statistically significant in the three age groups. The patient survival multivariate analysis did not achieve a statistically significant common factor in the three age groups.

CONCLUSIONS:

Five-year results show an excellent recipient survival and graft survival, especially in the youngest age group. Death with functioning graft is the leading cause of graft loss in patients >40 years. Early improvement of renal function and proteinuria together with strict control of cardiovascular risk factors are mandatory.

PMID:
23258810
PMCID:
PMC3526982
DOI:
10.1093/ndt/gfs544
[Indexed for MEDLINE]
Free PMC Article
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