Factors Influencing Long-Term Survival of Kidney Grafts Transplanted From Deceased Donors-Analysis Based on a Single-Center Experience

Transplant Proc. 2018 Jun;50(5):1281-1284. doi: 10.1016/j.transproceed.2018.03.009. Epub 2018 Mar 9.

Abstract

Background: Kidney transplantation is a routine procedure in the treatment of patients with kidney failure and requires collaboration of experts from different disciplines. Improvements in the procedure result from numerous factors.

Methods: The analyzed group consisted of 150 patients divided into 2 equal subgroups: long-term (>15 years) and short-term (<6 years) graft survival. The following factors were taken into consideration: graft survival time, HLA mismatches, recipient sex, sex compatibility, panel reactive antibodies (PRA), cold ischemia time (CIT), and cause of kidney insufficiency. Factors were analyzed in groups with the use of Student t and chi-square tests, Kruskal-Wallis analysis of variance (ANOVA), and multifactorial ANOVA.

Results: Basic statistical analysis revealed no significance between long-term and short-term survival groups in HLA mismatches, recipient sex, or sex compatibility. There was a very significant difference in CIT. ANOVA revealed no statistical difference between groups in recipient sex, sex compatibility, or recipient disease. There were more patients in the group with long-term survival with lower PRA. There were more women in the group with long-term survival who received kidneys from men. Multifactorial analysis revealed no interactions or independent influence of the selected factors.

Conclusions: CIT was a strong independent factor influencing graft survival. Recipient sex and cause of kidney insufficiency seemed to have no impact. Lower PRA was positively correlated with long-term survival. Women who received kidneys from men lived longer with functioning grafts.

MeSH terms

  • Adult
  • Analysis of Variance
  • Antibodies / blood
  • Antibodies / immunology
  • Chi-Square Distribution
  • Female
  • Graft Survival*
  • HLA Antigens / immunology
  • Humans
  • Kidney
  • Kidney Transplantation / methods
  • Kidney Transplantation / statistics & numerical data*
  • Male
  • Middle Aged
  • Renal Insufficiency / etiology
  • Renal Insufficiency / surgery*
  • Time Factors*
  • Treatment Outcome
  • Young Adult

Substances

  • Antibodies
  • HLA Antigens