Causes of Kidney Allograft Loss and Death in the United States, 2000-2010
Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN
Department of Surgery, University of Minnesota, Minneapolis, MN
Meeting: 2013 American Transplant Congress
Abstract number: 456
We sought to describe causes of kidney graft failure (GF) and death with function (DWF) by time posttransplant, and whether causes of immediate GF differed by donor quality (living, SCD, ECD, DCD). Kidney-alone transplants performed in 2000-2010 with follow-up through 10/31/11 were included (N=170,301). GF and deaths were identified using OPTN and CMS reports and SSA-identified deaths. Immediate GF, defined as discharged alive but without function, were significantly reduced in the more recent era (1.6%, 2005-10; 2.2%, 2000-04, p<0.05). Probability and causes of immediate GF differed by donor quality (Table).
| Living (406, 1.1% of total) | SCD (672, 1.6%) | ECD (274, 2.7%) | DCD (163, 2.4%) | |
| Graft Thrombosis | 54.4% (0.59%) | 39.9% (0.62%) | 29.6% (0.81%) | 35.0% (0.84%) |
| Primary Failure | 11.8% (0.13%) | 21.0% (0.33%) | 29.9% (0.82%) | 27.6% (0.67%) |
| Acute Rejection | 6.9% (0.07%) | 7.4% (0.12%) | 8.4% (0.23%) | 8.0% (0.19%) |
| Hyperacute Rejection | 3.0% (0.03%) | 2.5% (0.04%) | 2.2% (0.06%) | 2.5% (0.06%) |
| Recurrent Disease | 2.5% (0.03%) | 0.9% (0.01%) | 0.0% (0.0%) | 1.2% (0.03%) |
| Surgical Complications | 2.0% (0.02%) | 3.6% (0.06%) | 4.0% (0.11%) | 3.1% (0.07%) |
| Infection | 1.2% (0.01%) | 2.4% (0.04%) | 2.2% (0.06%) | 2.5% (0.06%) |
| Other | 18.2% (0.20%) | 22.3% (0.35%) | 23.7% (0.65%) | 20.2% (0.49%) |
For recipients discharged with function, all-cause GF rates and cause-specific rates of DWF differed by year posttransplant (Figure).
DWF was more common than GF. Acute rejection (AR) was the most frequent cause of GF during year 1, but AR declined in the most recent era [Odds Ratio (OR) 0.80 for 2005-10 vs. 2000-04, p<0.05]. During years 2-5 posttransplant, chronic rejection was most common and declined significantly in the most recent era (OR 0.48, p<0.05). Cardiovascular disease was the most common cause of DWF during year 1, but unknown cause became most common during years 2-5. In conclusion, rates of immediate GF have improved and GF due to rejection is less common in the most recent era.
To cite this abstract in AMA style:
Snyder J, Matas A, Leppke S, Israni A, Kasiske B. Causes of Kidney Allograft Loss and Death in the United States, 2000-2010 [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/causes-of-kidney-allograft-loss-and-death-in-the-united-states-2000-2010/. Accessed May 15, 2025.« Back to 2013 American Transplant Congress