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Survival of Patients With Peripheral Vascular Disease on Kidney Waitlist and After Transplantation: An Analysis of the United State Renal Data System

A. Brar,1 D. Stefanov,3 R. Jindal,2 N. Sumrani,4 D. John,4 F. Tedla,1 M. Salifu.1

1Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY
2Department of Surgery, Walter Reed National Military Medical Center, Uniformed Services University of Health Sciences, Bethesda, MD
3Division of Research, SUNY Downstate School of Medicine, Brooklyn, NY
4Department of Surgery, SUNY Downstate Medical Center, Brooklyn, NY.

Meeting: 2015 American Transplant Congress

Abstract number: A166

Keywords: Kidney transplantation, Outcome, Survival, Vascular disease

Session Information

Date: Saturday, May 2, 2015

Session Name: Poster Session A: Kidney: Cardiovascular and Metabolic

Session Time: 5:30pm-7:30pm

 Presentation Time: 5:30pm-7:30pm

Location: Exhibit Hall E

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Introduction: There is lack of information whether waitlisted dialysis patients with peripheral vascular disease (PVD) benefit from kidney transplantation.

Methods: We used a cohort of USRDS incident dialysis patients from 2001 to 2007, with follow-up through 2008. Patients with PVD under the age of 70 were included and divided into three groups; PVD patients on dialysis, waitlisted and PVD patients who received a first transplant. Standardized Mortality Ratios (SMR) and hazard ratios of death were calculated for statistical comparisons between the 3 groups. Time-dependent Cox regression models were used to compare mortality between waitlisted and transplanted patients.

Results: 23,699 incident dialysis patients met inclusion criteria; only 16.7% (n=3964) were waitlisted, of which 8.9 % (n=2,121) were transplanted. The annual death rates per 100 patient years was 22.86 in PVD patients on dialysis, 4.98 in waitlisted PVD patients and 4.86 in kidney transplant recipients. Using time-dependent Cox regression, there was no significant difference in mortality between transplanted and waitlisted patients in first 100 days after living donor transplantation (RR= 0.92, 95% Confidence Interval [C.I.] 0.50 to 1.69, p = 0.78). However there was a significantly lower risk of mortality compared to waitlisted patients in the two periods: 101days to 1 year (RR= 0.31, 95% C.I. 0.16 to 0.61, p=0.001) and longer than 1 year post transplantation (RR= 0.34, 95% C.I. 0.21 to 0.55, p=0.001). The benefit of deceased donor kidney transplantation over being on waitlist was not observed at any time point.

Conclusions: There was no survival advantage of deceased donor renal transplantation compared to remaining on the waitlist in PVD patients.

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To cite this abstract in AMA style:

Brar A, Stefanov D, Jindal R, Sumrani N, John D, Tedla F, Salifu M. Survival of Patients With Peripheral Vascular Disease on Kidney Waitlist and After Transplantation: An Analysis of the United State Renal Data System [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/survival-of-patients-with-peripheral-vascular-disease-on-kidney-waitlist-and-after-transplantation-an-analysis-of-the-united-state-renal-data-system/. Accessed January 25, 2021.

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