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.
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