Risk factors for kidney transplant acute rejection: a multivariate analysis

2001 ◽  
Vol 33 (1-2) ◽  
pp. 1112 ◽  
Author(s):  
R Kandaswamy ◽  
A Humar ◽  
W.D Payne ◽  
D.L Dunn ◽  
D.E.R Sutherland ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Acute Rejection ◽  
Kidney Transplant

scholarly journals Multivariate Analysis of Risk Factors for Acute Rejection in Early Corticosteroid Cessation Regimens Under Modern Immunosuppression

2005 ◽  
Vol 5 (11) ◽  
pp. 2740-2744 ◽  
Author(s):  
E. Steve Woodle ◽  
Rita R. Alloway ◽  
Joseph F. Buell ◽  
J. Wesley Alexander ◽  
Rino Munda ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Acute Rejection

scholarly journals Clinical characteristics, risk factors and outcome of severe Norovirus infection in kidney transplant patients: a case-control study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Julien Gras ◽  
Moustafa Abdel-Nabey ◽  
Axelle Dupont ◽  
Jérôme Le Goff ◽  
Jean-Michel Molina ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Rejection ◽  
Kidney Transplant ◽  
Case Control Study ◽  
De Novo ◽  
Case Control ◽  
Duration Of Symptoms ◽  
Factors Associated ◽  
Control Study

Abstract Background Human Norovirus (HuNoV) has recently been identified as a major cause of diarrhea among kidney transplant recipients (KTR). Data regarding risk factors associated with the occurrence of HuNoV infection, and its long-term impact on kidney function are lacking. Methods We conducted a retrospective case-control study including all KTR with a diagnosis of HuNoV diarrhea. Each case was matched to a single control according to age and date of transplantation, randomly selected among our KTR cohort and who did not develop HuNoV infection. Risk factors associated with HuNoV infection were identified using conditional logistic regression, and survival was estimated using Kaplan-Meier estimator. Results From January 2012 to April 2018, 72 cases of NoV diarrhea were identified among 985 new KT, leading to a prevalence of HuNoV infection of 7.3%. Median time between kidney transplantation and diagnosis was 46.5 months (Inter Quartile Range [IQR]:17.8–81.5), and the median duration of symptoms 40 days (IQR: 15–66.2). Following diagnosis, 93% of the cases had a reduction of immunosuppression. During follow-up, de novo Donor Specific Antibody (DSA) were observed in 8 (9%) cases but none of the controls (p = 0.01). Acute rejection episodes were significantly more frequent among cases (13.8% versus 4.2% in controls; p = 0,03), but there was no difference in serum creatinine level at last follow-up between the two groups (p = 0.08). Pre-transplant diabetes and lymphopenia below 1000/mm3 were identified as risks factors for HuNoV infection in multivariate analysis. Conclusion HuNoV infection is a late-onset and prolonged infection among KTR. The current management, based on the reduction of immunosuppressive treatment, is responsible for the appearance of de novo DSA and an increase in acute rejection episodes.

Risk factors and prognosis of late acute rejection in Chinese kidney transplant recipients

Nephrology ◽  
2017 ◽  
Vol 22 (12) ◽  
pp. 985-992
Author(s):  
Maggie Ming Yee Mok ◽  
Maggie Kam Man Ma ◽  
Desmond Yat Hin Yap ◽  
Gavin Sheung Wai Chan ◽  
Man Fai Lam ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Rejection ◽  
Kidney Transplant ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients

Risk Factors for Graft Loss in Pediatric Renal Transplant Recipients After Transfer of Care

2016 ◽  
Vol 26 (4) ◽  
pp. 356-364 ◽  
Author(s):  
Bethany Coyne ◽  
Patricia J. Hollen ◽  
Guofen Yan ◽  
Kenneth Brayman
Keyword(s):  
Risk Factors ◽  
Acute Rejection ◽  
Kidney Transplant ◽  
Graft Loss ◽  
National Database ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Transfer Of Care ◽  
Medication Noncompliance

Background: Improvements in transplantation have increased the survival of children after kidney transplantation. These patients have complex needs, and the current medical system is not prepared to effectively transfer the care of these individuals from pediatric to adult health-care systems. Too often, transfer occurs during moments of crisis and is associated with poor outcomes. Objective: The aim of this study was to use a national database, the Scientific Registry of Transplant Recipients, to test the hypothesis that the increased risk of graft loss after transfer of care (from pediatric to adult services) for young adult kidney transplant recipients over a 2- to 3-year posttransfer follow-up period was related to these posttransfer risk factors (medication noncompliance, acute rejection, insurance status). Design: A retrospective, longitudinal, correlational design using secondary data was used to evaluate the transfer of care of 250 kidney transplant recipients (ages 16-25). Results: Seventy-seven (30.8%) individuals lost their graft within 3 years after transfer of care. Medication noncompliance, acute rejection, and serum creatinine >2.0 mg/dL at transfer were significant predictors of graft loss after accounting for multiple other factors. Conclusion: These individuals are at risk for graft loss after transfer of care and may benefit from increased personalized care during this risky period.

Early acute rejection after liver transplantation (LT): Multivariate analysis of risk factors

2000 ◽  
Vol 32 ◽  
pp. 142
Author(s):  
N. Gómez-Manero ◽  
J.I. Herrero ◽  
J. Quiroga ◽  
B. Sangro ◽  
F. Pardo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Transplantation ◽  
Multivariate Analysis ◽  
Acute Rejection

MO940ACUTE REJECTION IN KIDNEY RETRANSPLANTATION: RISK FACTORS AND IMPACT IN GRAFT SURVIVAL

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Rita Leal ◽  
Clara Pardinhas ◽  
Luís Rodrigues ◽  
Maria Guedes Marques ◽  
Lidia Santos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Rejection ◽  
Kidney Transplant ◽  
Graft Survival ◽  
Graft Failure ◽  
Graft Loss ◽  
First Year ◽  
Post Transplant ◽  
Increased Risk

Abstract Background and Aims Kidney retransplantation confers a robust survival benefit over dialysis in selected patients and recent data has shown second graft outcomes similar to those of a first graft. However, the management of these patients is challenging, particularly due to allosensitization and an increased risk of acute rejection, which are related with poorer graft survival. The recognition of risk factors to acute rejection, dependent on the first and second graft, might help us to personalize standard care and achieve similar graft survival rates to patients with a first transplant. Our aim was to identify risk factors to second graft acute rejection, and the impact of acute rejection in graft failure. Method We performed a retrospective, longitudinal study including all patients submitted to a second kidney transplant between January 2008 and December 2019, excluding patients with more than 2 grafts or multi-organ transplant. Demographic, clinical and histocompatibility data from the donor and receptor were collected from our unit database. Delayed graft function was defined as the need of dialysis in the first week post-transplant. All acute rejection episodes were biopsy proven, according to Banff 2017 criteria. Follow-up was defined at 1st June 2020 for functioning grafts or at graft failure, with a mean time of 94±42 months. Results We included 109 patients of which 70 males (64%), mostly Caucasian (97%), with a mean age of 43±12 years at second kidney transplant. The main causes of end stage renal disease were glomerular disease (37%), undetermined cause (34%), and urological pathology (15%). First kidney transplant was performed before the year 2010 in 95 patients (87%). The median time of first graft survival was 75 months (IQR 58.5-91.4) and the main causes of first graft loss were chronic allograft nephropathy (N=62, 70.5%) and 11 patients (12.5%) presented primary disfunction due to surgical/vascular complications. During follow-up, 20 patients (18%) presented biopsy proven acute rejection: 3 patients borderline changes, 10 patients T cell mediated and 7 patients antibody mediated, the majority during the first-year post-transplant (N=17, 85%). The risk factors for second graft rejection are summarized in table 1. First year graft survival of the second transplant was 90% and survival at follow up was 72.5% (N=79). Acute rejection was an important risk factor for graft loss (OR 6.548 (95%CI[2.292 - 18.703]), p<0.01). Conclusion Worst outcomes in first kidney transplant, such as acute rejection, primary dysfunction and lower graft survival were related with an increased risk of acute rejection in second graft outcomes, and consequently a higher risk of graft failure.

scholarly journals Invasive Fungal Diseases in Kidney Transplant Recipients: Risk Factors for Mortality

2020 ◽  
Vol 9 (6) ◽  
pp. 1824 ◽  
Author(s):  
Hyeri Seok ◽  
Kyungmin Huh ◽  
Sun Young Cho ◽  
Cheol-In Kang ◽  
Doo Ryeon Chung ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Acute Rejection ◽  
Bacterial Infection ◽  
Kidney Transplant ◽  
Deceased Donor ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Related Mortality

Background: Invasive fungal disease (IFD) is common in solid organ transplant (SOT) recipients and contributes to high morbidity and mortality. Although kidney transplantation (KT) is a commonly performed SOT, data on the risk factors for IFD-related mortality are limited. Methods: A 1:2 retrospective case-control study was performed in an experienced single center in the Republic of Korea. We reviewed the electronic medical records of patients with IFD after KT between February 1995 and March 2015. Results: Of 1963 kidney transplant recipients, 48 (2.5%) were diagnosed with IFD. The median interval from KT to IFD diagnosis was 172 days. Invasive aspergillosis (IA) was the most common, followed by invasive candidiasis (IC). Diabetes mellitus (DM) (odds ratio (OR) 3.72, 95% confidence interval (CI) 1.34–10.31, p = 0.011) and acute rejection (OR 3.41, 95% CI 1.41–8.21, p = 0.006) were associated with IFD development. In the subgroup analyses, concomitant bacterial infection was associated with IC development (OR 20.10, 95% CI 3.60–112.08, p = 0.001), and delayed graft function was associated with IA occurrence (OR 10.60, 95% CI 1.05–106.84, p = 0.045). The 12-week mortality rate in all patients was 50.0%. Mortality rates were significantly higher in older patients (adjusted hazard ratio (aHR) 1.06, 95% CI 1.02–1.11, p = 0.004), or those with DM (aHR 2.61, 95% CI 1.02–6.68, p = 0.044), deceased donor transplantation (aHR 2.68, 95% CI 1.03–6.95, p = 0.043), lymphocyte-depleting antibody usage (aHR 0.26, 95% CI 0.08–0.80, p = 0.019), acute rejection (aHR 0.38, 95% CI 0.15–0.97, p = 0.044), and concomitant bacterial infection (aHR 8.76, 95% CI 1.62–47.51, p = 0.012). Conclusions: A total of 50% of IFD cases occurred six months or later after transplantation. The IFD-related mortality rate was high in kidney transplant recipients despite the low incidence. DM and acute rejection were associated with high mortality, as well as IFD development. As old age, deceased donor transplantation, lymphocyte-depleting antibody usage, and concomitant bacterial infection are risk factors for IFD-related mortality, efforts for its early diagnosis and appropriate treatment are required.

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