The incidence of mortality in the general population is significantly higher in winter than in summer. It is unknown whether such a seasonal difference exists for mortality or graft failure among kidney transplant recipients in the US.

We analyzed UNOS data from 2000-2014 to assess whether the observed distribution of deaths and graft failures (excluding deaths) by month differed significantly from expected. Deaths and failures within 90 days of transplantation were excluded.

A total of 62,973 deaths and 54,128 graft failures occurred, including 27,517 (50.8%) graft failures due to chronic rejection, 7,355 (13.6%) due to acute rejection, 3,674 (6.8%) due to recurrent disease, and 15,582 (28.8%) due to other causes. The distribution of deaths and graft failures both differed significantly from expected (p<0.001). The pattern of deaths was similar to that found in the general population, with an excess in December-February and a deficit in May-September. The pattern of graft failures was somewhat different, with an excess in January-April and a deficit in July-December (p<0.001). Similar results were observed for graft failures due to chronic rejection (p<0.001) and other causes (p=0.02), but not for acute rejection (p=0.74) or recurrent disease (p=0.55).The reasons for these seasonal differences are unknown. Potential explanations include changes in insurance coverage, medication adherence and other behaviors, sunlight exposure, and other factors affecting the immune system. Further studies are necessary to identify specific mechanisms.

CITATION INFORMATION: Astor B, Melamed M, Mandelbrot D, Djamali A. Seasonality of Mortality and Graft Failure Among Kidney Transplant Recipients in the US. Am J Transplant. 2017;17 (suppl 3).

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