Muhammed Emre SEVİM, Fatma YİLMAZ AYDİN, Emre AYDİN

Evaluation of factors affecting morbidity, mortality, and graft survival in kidney transplant patients

Objective: The aim of this study is to examine and evaluate the clinical findings and affecting factors related to graft and patient survival in kidney transplant patients at Dicle University Hospital. Method: 72 patients who underwent kidney transplantation at Dicle University Medical Faculty Hospital between January 2012 and September 2019 were included in the study. Demographic characteristics of patients, transplantation types, clinical and laboratory findings, pre-transplant dialysis types, renal failure etiologies, post-transplant complications, average patient and graft survival times and patient characteristics at the time of diagnosis, laboratory values, and treatment modalities were investigated. Results: In this study, the data collected from 72 patients who had kidney transplantation and 68 donors was analysed. The mean age of the patients was 32,7±13,8 years. 31 of patients were female, 41 were male. 56 of the transplants were performed living donors and 12 from cadavers. 9 patients died. The mean of patient survival was 94±3,4 months. Graft loss occured in 15 patients. The mean of graft survival was 86±4,3 months. Acute rejection occured in 10 patients. Chronic allograft nephropathy occured in 19 patients. Chronic allograft nephropathy was found more frequently in patients with acute rejection (p=0.017). In addition, graft loss was more common in patients with chronic allograft nephropathy (p=0.002). The dialysis duration was less than 12 months, and the BMI of the recipient was below 30 had a positive effect on patient survival. Conclusion: Recipient obesity and long-term dialysis programs reduce patient survival. In addition, prevention of rejection has a positive effect on patient and graft survival.

Anahtar Kelimeler:

Kidney Transplantation, Acute Rejection, Graft Survival

Evaluation of factors affecting morbidity, mortality, and graft survival in kidney transplant patients

Keywords:

Kidney Transplantation, Acute Rejection, Graft Survival,

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1. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney inter., Suppl. 2013; 3: 1–150.
2. Süleymanlar G, Utaş C, Arinsoy T, et al. A population-based survey of Chronic Renal Disease In Turkey--the CREDIT study. Nephrol Dial Transplant. 2011 Jun; 26: 1862–71.
3. Anderson J and Glynn LG: Definition of chronic kidney disease and measurement of kidney function in original research papers: A review of the literature. Nephrol Dial Transplant 2011; 26: 2793- 8.
4. Saygılı E S, S eyahi N , D urak H , e t a l. G reft sağkalımını etkileyenfaktörlerin transplant böbrekbiyopsileriyledeğerlendirilmesi. Dicle Med J (2018) 45: 237-44.
5. Choo SY. The HLA System: Genetics, Immunology, Clinical Testing, and Clinical Implications. Yonsei Med J. 2007 Feb 28; 48: 11-23.
6. Koçak H. Postransplant Erken DönemMedikalKomplikasyonlar. TransplantasyonNefrolojisi 2016 Ankara. 59-64.
7. Khan H, Mubarak M, Aziz T, et al. Prevalence and risk factors for early chronic allograft nephropathy in a live related renal transplant program. J Nephropathol. 2014; 3: 69-79.
8. Mateu LMP, Calabuig AS, Plaza LC, Esteve AF. Acute rejection and late renal transplant failure: risk factors and prognosis. Nephrol Dial Transplant. 2004 Jun;19 Suppl 3iii38-42.
9. Grinyo JM, Saval N, Campistol JM. Clinical assessment and determinants of chronic allograft nephropathy in maintenance renal transplant patients. Nephrol Dial Transplant. 2011; 26: 3750-5.
10. Schwarz A, Mengel M, Gwinner W, et al. Risk factors for chronic allograft nephropathy after renal transplantation: a protocol biopsy study. Kidney Int. 2005 Jan; 67: 341-8.
11. Süleymanlar G, Ateş K, Seyahi N et al. National Nephrology, Dialysis and Transplantation Registry Report of Turkey 2019.
12. Ay N , K aya S , C icek N , B ahadır MV. BöbrekTransplantasyonuVerilerimiz; Diyarbakır’da Tek Merkez Deneyimi. Dicle Med J (2017); 44: 199- 204.
13. Rumyantzev AG, Hurdle JF, Scandling J, et al. Duration of end-stage renal disease and kidney transplant outcome. Nephrol Dial Transplant. 2005 Jan; 20: 167-75.
14. Zhang H, Wei Y, Liu L, et al. Different Risk Factors for Graft Survival Between Living-Related and Deceased Donor Kidney Transplantation. Transplant Proc. 2018 Oct; 50: 2416-20.
15. Lafranca JA, IJermans JNM, Betjes MGH, Dor FJMF. Body mass index and outcome in renal transplant recipients: a systematic review and metaanalysis. BMC Med. 2015 May 12; 13: 111.