Background: The understanding of the main causes of allograft losts and related factors is a critical in the sucess of kidney transplantation programs.

Objective: The aim of this study was to identify which are the factors associated to the allograft loss in a mexican cohort of kidney transplant recipients.

Methods: All consecutive adult kidney allograft recipients in an academic-hospital in Mexico City were included. Primary non-function allograft, recipients of two solid organs and deaths in the first 24 hours after sugery were excluded. Kidney allograft loss censured to death was defined as the permanent requirement of dialysis or a new allograft.

Results: We included 303 kidney transplant recipients between 2004 and 2015. The median of age was 26 years old (21-34), 55% male, 86.8% living-donors, 84.5% with unknow cause of CKD, 82% recieved an anti-IL-2 receptor antibodies as induction therapy and 85% maintenance with calcineurin inhibitor, mycophenolate and prednisone, the median of follow-up was 54 months (27-92). Thirty-six patients lost the graft, the main causes were unknown (37.4%), antibody mediated rejection (25.7%), mixed rejection (20%). The probability of survival beyond eleven years was superior in the adherent vs non-adherent group (91.3 % vs 18.3; p<0.001). Non adherence was associated with an increase of antibody mediated rejection (OR 5.6,[2.0-15.4]).Multivariable analysis showed that deceased donor (hazard ratio [HR], 2.61; 95% confidence interval 95% CI], 1.01-6.00, P=0.03), non adherence (HR, 2.5; 95% CI, 0.6-10.9; P=0.23) and non adherence x time (HR, 1.03; 95% CI, 1.0-1.06; P=0.03) increased the risk of allograft loss. Non adherent patients tend to be younger (23 years-old [20-31] vs (27 years-old, [21-34], p=0.06) and had less time on dialysis before transplant (14 months [10.5-30.5] vs 22 months [12-45), p=0.05] months than adherent patients.

Conclusions: The main cause of graft loss was rejection. Non adherence was the main risk factor for allograft loss, and the risk conferred by it increased with time.Younger patients with shorter time between ERC diagnosis and kidney transplant tend to be less adherent.

CITATION INFORMATION: Merino-López M, Flores-Gama C. Impact of Non-Adherence in a Cohort of Kidney Transplant Recipients. Am J Transplant. 2017;17 (suppl 3).

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