Kidney Transplant Graft Loss – Continued Room for Improvement
U MN, Mpls, MN
Meeting: 2013 American Transplant Congress
Abstract number: C1325
Identification of causes of graft loss (GL)allows targeted preventive therapies. We studied actuarial GL in 5 decades (1960-2010), for adult 1st kidney tx recips. Donor and recipient demographics have changed over time: ⇓ in % DDs; of DDs, ↑ in ECDs; of LDs, a steady ↑ in LURDs (p<.0001); ↑ mean donor age (p<.0001); ↑ mean recipient age (60s=32 yrs; 70s=37 yrs; 80s=39 yrs; 90s=46 yrs; 2000s=51 yrs) (p<.0001); ↑ non-whites (p<.0001).
Causes of GL in the 1st year (by decade) and in Years 1-5 posttx are shown in Table 1 (early GL to thrombosis and tech failure are grouped). There have been ⇓ing losses from AR, CR, Tech/thrombosis, & DwF. ECDs (vs SCDs or LDs) had ↑ GL < 5 yrs to AR, CR/IFTA, and DwF. After 5 yrs, ECD recips had ↑ DwF due to CV disease (p=.05) (data not shown).
| % Grafts | ||||||
| 1960s (n=105) | 1970s (n=847) | 1980s (n=1020) | 1990s (n=1076) | 2000s (n=1078) | ||
| Year 1 | ||||||
| AR | 14% | 7% | 3% | 1.5% | .5% | |
| CR | 3% | 5% | 1.5% | 1% | .3% | |
| Tech/Throm | 10% | 4% | 2% | 2% | .6% | |
| DwF | 14% | 9% | 5% | 4% | 2% | |
| Lost to f/u | 0% | 0.7% | 0% | 0.5% | 0% | |
| Func* | 55% | 71% | 86% | 90% | 96% | |
| Years 1-5 | ||||||
| AR | 1.7% | .2% | .7% | .4% | 1.1% | |
| CR | 9% | 5% | 7% | 5% | 3.5% | |
| Nonad | 0 | 2% | 1.5% | 1% | ||
| Recurrence | — | .2% | .7% | .9% | .7% | |
| DwF | 17% | 14% | 9% | 9% | 7% | |
| Lost to f/u | 0% | 0% | 0.6% | 1% | 0.7% | |
| Func* | 72% | 80% | 79% | 81% | 85% | |
Actuarial rates of GL for AR improved by decade til the 90s (Table 2; comparisons vs 2000s truncated @ 10yrs); rates for CR/IFTA have shown recent (since 90s) improvement. Recent aggressive screening for thrombophilias and preventive anti-coagulation have resulted in signif ⇓ in thromboses. In spite of changing demographics (older populati
To cite this abstract in AMA style:
Matas A, Gillingham K, Ibrahim H. Kidney Transplant Graft Loss – Continued Room for Improvement [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/kidney-transplant-graft-loss-continued-room-for-improvement/. Accessed November 22, 2024.« Back to 2013 American Transplant Congress