The First Year Renal Function as a Predictor of Long-Term Graft Survival After Kidney Transplantation

• Published in: Transplantation proceedings 2009-03, Vol.41 (2), p.648-650
• Main Authors: Helal, I, Abderrahim, E, Ben Hamida, F, Ounissi, M, Essine, S, Hedri, H, Bardi, R, Elgorgi, Y, El Younsi, F, Ben Maiz, H, Ben Abdallah, T, Kheder, A
• Format: Article
• Language: English
• Subjects: Adult; Analysis of Variance; Biological and medical sciences; Female; Follow-Up Studies; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Graft Rejection - epidemiology; Graft Survival - physiology; Histocompatibility Testing; Humans; Kidney Transplantation - mortality; Kidney Transplantation - physiology; Male; Medical sciences; Predictive Value of Tests; Regression Analysis; Renal Replacement Therapy - statistics & numerical data; Retrospective Studies; Risk; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Survivors; Time Factors; Tissue, organ and graft immunology; Treatment Failure; Treatment Outcome; Young Adult
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2009.02.036

Abstract This study examined the impact of graft function at the end of the first year after kidney transplantation on long-term graft survival. We analyzed the roles of serum creatinine (Scr) and other variables as predictors of graft survival among 235 adult kidney transplant patients. The subjects were divided into 3 groups according to their Scr at the end of the first year: group 1, Scr < 100 μmol/L; group 2, 100 μmol/L ≤ Scr ≤ 150 μmol/L; and group 3, Scr >150 μmol/L. The annual rate of graft loss of 0.7% (95% confidence interval [CI], 0.63–0.77) in group 1, was lower than those in group 2 (2.1%; 95% CI, 2.02–2.18; P < .0001) and group 3 (6%; 5.74–6.26; P < .0001). Regression analysis showed the role of recipient age at the time of operation, and Scr level at the end of the first year to be independent predictors of graft loss. Graft survival was not influenced by any other studied parameter, including donor age, year of procedure, warm ischemia time, history of acute tubular necrosis, and occurrence of an acute rejection episode. We conclude that the 1-year Scr value predicts long-term renal graft survival, representing a simple, practical tool to identify recipients with an high risk for late graft failure.