Collaboration between local nephrologists and the transplant centre ensures good outcomes in post-transplant care

Background Despite substantial improvements in short-term kidney allograft survival, median long-term survival remains at a standstill. It is unclear whether and to what extent a transplant centre’s post-transplant care influences long-term outcomes. Methods We retrospectively analysed 501 single ki...

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Bibliographic Details
Published in:Clinical kidney journal 2023-02, Vol.16 (2), p.331-341
Main Authors: Kaufmann, Yves L, von Moos, Seraina, Spitznagel, Tahm, Matter, Laurenz S, Mueller, Thomas F, Schachtner, Thomas
Format: Article
Language:English
Subjects:
Antibodies
Immunotherapy
Kidneys
Organ transplant recipients
Original
T cells
Transplantation
Viral antibodies
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Summary:Background Despite substantial improvements in short-term kidney allograft survival, median long-term survival remains at a standstill. It is unclear whether and to what extent a transplant centre’s post-transplant care influences long-term outcomes. Methods We retrospectively analysed 501 single kidney transplant recipients (KTRs) who underwent transplantation between 2009 and 2018 and did not develop rejection or de novo donor-specific antibodies (dnDSA) within the first post-transplant year. After that, KTRs were either followed exclusively every 3 months by the transplant centre (n = 197) or every 3 months by local nephrologists (n = 304) with only yearly follow-up by the transplant centre. We analysed kidney allograft outcomes regarding estimated glomerular filtration rate (eGFR) decline, proteinuria, development of dnDSA and rejection. Results No differences between the two groups were observed in the baseline characteristics and the characteristics at the end of the first post-transplant year (P > .05). KTRs followed by local nephrologists were comparable to KTRs followed by the transplant centre concerning patient survival (P = .541), kidney allograft survival (P = .385), eGFR decline (P = .488), progression of proteinuria (P > .05), the development of dnDSA (P = .335) and T-cell-mediated rejection (P = .480). KTRs followed by the transplant centre were more likely to undergo indication biopsies in case of allograft dysfunction and dnDSA (P 
ISSN:2048-8505
2048-8513
DOI:10.1093/ckj/sfac232