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Kidney Transplant Outcomes in Recipients with Physical Impairments

A. G. Thomas1, J. Ruck2, N. Chu2, D. Agoons2, A. Shaffer2, C. Haugen2, H. Ying2, B. Swenor2, S. Norman3, J. Garonzik-Wang2, D. Segev2, M. McAdams-DeMarco2

1Epidemiology, UNC Chapel Hill, Chapel Hill, NC, 2Johns Hopkins University, Baltimore, MD, 3University of Michigan, Ann Arbor, MI

Meeting: 2019 American Transplant Congress

Abstract number: D170

Keywords: Graft survival, Kidney transplantation, Multicenter studies, Risk factors

Session Information

Date: Tuesday, June 4, 2019

Session Name: Poster Session D: Non-Organ Specific: Disparities to Outcome and Access to Healthcare

Session Time: 6:00pm-7:00pm

 Presentation Time: 6:00pm-7:00pm

Location: Hall C & D

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*Purpose: Disability in general has been associated with poor outcomes in KT recipients. However, disability can be derived from various components, specifically visual, hearing, physical, and walking impairments. We hypothesized that these different impairments compromise the patient through different mechanisms and, as such, might impact different aspects of KT outcomes.

*Methods: In our prospective 2-center cohort study (6/2013-6/2017), 465 recipients reported hearing, visual, physical, and walking impairments prior to KT. We used hybrid registry-augmented Cox regression, by adjusting for confounders using the national KT population (SRTR N=66,891), to assess the independent association between impairments and post-KT outcomes (death-censored graft failure [DCGF] and mortality).

*Results: 31.6% of recipients reported at least one impairment (hearing=9.3%, visual=16.6%, physical=9.1%, and walking=12.1%). Visual impairment was associated with a 3.36-fold (95%CI:1.17-9.65; p=0.02) higher DCGF risk; however, hearing (aHR=2.77;95%CI:0.78-9.82), physical (aHR=0.67; 95%CI:0.08-3.35), and walking (aHR=0.50;95%CI:0.06-3.89) impairments were not. Walking impairment was associated with a 3.13-fold (95%CI:1.32-7.48; p=0.01) higher mortality risk; however, visual (aHR=1.20;95%CI:0.48-2.98), hearing (aHR=1.01;95%CI:0.29-3.47), and physical (aHR=1.16;95%CI:0.34-3.94) impairments were not.

*Conclusions: In this cohort, 31.6% of KT recipients reported 1 impairment. Recipients with visual impairment were at higher DCGF risk; those with walking impairments were at higher mortality risk. No other impairments were associated with post-KT outcomes. Transplant centers should identify recipients with visual and walking impairments who might benefit from targeted interventions pre-KT, additional supportive care, and close post-transplant monitoring.

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To cite this abstract in AMA style:

Thomas AG, Ruck J, Chu N, Agoons D, Shaffer A, Haugen C, Ying H, Swenor B, Norman S, Garonzik-Wang J, Segev D, McAdams-DeMarco M. Kidney Transplant Outcomes in Recipients with Physical Impairments [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/kidney-transplant-outcomes-in-recipients-with-physical-impairments/. Accessed February 25, 2021.

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