The Impact of Aorto-Iliac Calcifications on Patient and Graft Survival in Renal Transplant Recipients Using the TASC II Classification
1Department of Transplantation Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
2Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, Netherlands
3Department of Vascular Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
4Department of Radiology, Erasmus University Medical Center, Rotterdam, Netherlands.
Meeting: 2018 American Transplant Congress
Abstract number: 537
Keywords: Graft survival, Kidney transplantation, Vascular disease
Session Information
Date: Tuesday, June 5, 2018
Session Name: Concurrent Session: Kidney: Perioperative Considerations
Session Time: 4:30pm-6:00pm
Presentation Time: 4:42pm-4:54pm
Location: Room 303
Introduction: Kidney transplantation (KTx) is the therapy of choice in patients with end-stage renal disease. Aorto-iliac calcifications (AIC) are a relative contra-indication for KTx, even though the influence on patient and graft survival remains poorly explored. The aim of this study is to assess the impact of aorto-iliac calcifications on patient and graft survival using the TASC II classification.
Methods: This retrospective single-center study included all KTx recipients from 2000-2016 who had imaging-proven pre-transplantation aorto-iliac stenotic lesions. Patients were classified according to the TASC II classification. All patients transplanted between 2007-2011 without aorto-iliac stenotic lesions were used as a control group. Primary endpoints were patient and graft survival. Cox proportional hazards model was used to evaluate risk factors for mortality and graft loss.
Results: Aorto-iliac stenotic lesions were observed in 78 patients before kidney transplantation. In total, 773 patients were included as a control group. Overall patient survival was decreased for every TASC II class (TASC II A: p=.001; B: p=.004, C: p<.001, D: p<.001). No significant difference was found for 90-day mortality (TASC II A p=.165; B p=1.000; C p=1.000) and 1-year mortality (TASC II A p=.143; B p=1.000; C p=1.000) in patients with TASC II A, B or C lesions. Patients with TASC II D lesions had significantly higher 90-day (p=.006) and 1-year (p <.001) mortality. Death-censored graft survival was not significantly decreased for TASC II A, B and C compared to the control group (TASC II A p=.792; B p=.950; C p=.160). Multivariate Cox model showed that any TASC II lesion was not a predictor of overall mortality (hazard ratio (HR) 1.52 confidence interval (CI) 0.94-2.46) or graft loss (HR 1.72; CI 0.94-3.17).
Conclusion: Kidney transplantation is a safe procedure in patients with TASC II A, B and C lesions. Graft survival is unaffected by aorto-iliac stenotic lesions. Therefore, aorto-iliac calcifications should not be a contra-indication for kidney transplantation.
CITATION INFORMATION: Rijkse A., van der Zijden M., Roodnat J., Ten Raa S., Bijdevaate D., Muller K., IJzermans J., Kimenai H., Minnee R. The Impact of Aorto-Iliac Calcifications on Patient and Graft Survival in Renal Transplant Recipients Using the TASC II Classification Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Rijkse A, Zijden Mvander, Roodnat J, Raa STen, Bijdevaate D, Muller K, IJzermans J, Kimenai H, Minnee R. The Impact of Aorto-Iliac Calcifications on Patient and Graft Survival in Renal Transplant Recipients Using the TASC II Classification [abstract]. https://atcmeetingabstracts.com/abstract/the-impact-of-aorto-iliac-calcifications-on-patient-and-graft-survival-in-renal-transplant-recipients-using-the-tasc-ii-classification/. Accessed March 1, 2021.« Back to 2018 American Transplant Congress