Mortality and Morbidity in Kidney Transplant Recipients with a Failing Graft

N. N. Lam¹, D. J. Boyne², R. R. Quinn², P. C. Austin³, B. R. Hemmelgarn², P. Campbell¹, G. A. Knoll⁴, L. Tibbles², S. Yilmaz², H. Quan², P. Ravani²

¹University of Alberta, Edmonton, AB, Canada, ²University of Calgary, Calgary, AB, Canada, ³ICES, Toronto, ON, Canada, ⁴University of Ottawa, Ottawa, ON, Canada

Meeting: 2019 American Transplant Congress

Abstract number: 7

Keywords: Graft failure, Kidney transplantation, Morbidity, Mortality

Session Information

Session Name: Concurrent Session: Kidney Complications: Late Graft Failure I

Session Type: Concurrent Session

Date: Sunday, June 2, 2019

Session Time: 2:30pm-4:00pm

Presentation Time: 2:54pm-3:06pm

Location: Veterans Auditorium

*Purpose: Due to their history of renal disease and exposure to immunosuppression, kidney transplant recipients with a failing graft may be at higher risk of adverse outcomes compared to non-transplant controls.

*Methods: We performed a retrospective cohort study of kidney transplant recipients with a failing graft in Alberta, Canada (2002-2015), defined as at least two estimated glomerular filtration rate measurements between 15-30 mL/min/1.73 m² that were 90-365 days apart. We propensity-score matched (1:1) recipients with a failing graft to non-transplant controls and used Cox regression to compare the hazards of death between the two groups and negative binomial regression to compare the rates of hospitalization.

*Results: We identified 612 kidney transplant recipients with a failing graft and matched 573 (94%) of them to non-transplant controls with a similar degree of kidney dysfunction. The median age of the matched cohort was 57 years and 40% were women. Compared to matched non-transplant controls, recipients with a failing graft had a higher hazard of death (hazard ratio 1.34, 95% confidence interval [CI] 1.11-1.62; p=0.003) and a higher rate of all-cause hospitalization (rate ratio 1.67, 95% CI 1.43-1.95; p<0.001). Kidney transplant recipients also had a higher rate of several cause-specific hospitalizations including genitourinary, cardiovascular, and infectious causes.

*Conclusions: A failing kidney transplant is associated with an increased burden of mortality and morbidity related to chronic kidney disease. This information may assist the discussion of prognosis in kidney transplant recipients with a failing graft and the design of strategies to minimize risks.

To cite this abstract in AMA style:

Lam NN, Boyne DJ, Quinn RR, Austin PC, Hemmelgarn BR, Campbell P, Knoll GA, Tibbles L, Yilmaz S, Quan H, Ravani P. Mortality and Morbidity in Kidney Transplant Recipients with a Failing Graft [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/mortality-and-morbidity-in-kidney-transplant-recipients-with-a-failing-graft/. Accessed May 9, 2025.

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