Haptoglobin 2-2 Genotype, Patient, and Graft Survival in Renal Transplant Recipients

Background: Cardiovascular disease is the leading cause of death in renal transplant recipients. An association between haptoglobin genotype 2-2 and cardiovascular disease has been found in patients with diabetes mellitus and liver transplant recipients. To date, the role of haptoglobin genotype after renal transplantation has not been studied. Methods: In this single-center retrospective cohort study of 1975 adult Norwegian transplant recipients, who underwent transplantation between 1999 and 2011, we estimated the risk of all-cause and cardiovascular mortality and overall and death-censored graft loss for patients with haptoglobin genotype 2-2 compared to genotype 2-1 or 1-1, after adjustment for confounders and competing risks. Results: We found no associations between haptoglobin genotype 2-2 and cardiovascular mortality (subdistributional hazard ratio 1.08, 95% confidence interval 0.78-1.49; P = .63). We also failed to detect any association between haptoglobin 2-2 genotype and all-cause mortality, overall graft loss, and death-censored graft loss. Similar results were found in the subpopulation of transplant recipients with diabetes. Conclusion: In this large cohort of kidney transplant recipients, we could not demonstrate any association between haptoglobin 2-2 genotype and patient or graft survival after renal transplantation.

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MO998EARLY VERSUS LATE ACUTE GRAFT PYELONEPHRITIS: A RETROSPECTIVE ANALYSIS OF GRAFT AND PATIENT OUTCOMES

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab111.0022 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Anupma Kaul ◽

Thomas Mathews

Keyword(s):

Renal Transplant ◽

Graft Survival ◽

Patient Survival ◽

Univariate Analysis ◽

Graft Loss ◽

Renal Transplant Recipients ◽

Transplant Recipients ◽

Kaplan Meier ◽

Baseline Characteristics ◽

Acute Graft

Abstract Background and Aims Acute graft pyelonephritis(AGPN) is thought to affect graft and patient survival among renal transplant recipients. Our objective was to compare these outcomes in those having early AGPN(<6 months from transplant) versus those having late AGPN(>6months from transplant) Method This retrospective study analyzed 150 patients who had AGPN over a period of 8 years from 2005 to 2013. They were divided into early AGPN group and late AGPN group. Their baseline characteristics were compared. Predictors of graft loss and mortality were compared using logistic regression analysis. Graft survival and patient survival were analyzed using Kaplan-Meyer survival plots Results A total of 150 patients with AGPN were analyzed. Of these 55.3% (n=83) had early AGPN and 44.7% (n=67) had late AGPN. These two groups were comparable regarding baseline characteristics and immunosuppression. In early AGPN group, 13.3% (n=11) patients had CMV disease during follow up compared to 3% (n=2) in late AGPN group(p<0.05). In the early AGPN group, 26.5% (n=22) had prolonged Foley’s catheterization (>5days) following transplant surgery compared to 7.5% (n=5) in late AGPN group (p<0.05). In the early AGPN group, 38.6% (n=32) had prolonged DJ stent in-situ (>2weeks) following transplant surgery compared to 19.4% (n=13) in the late AGPN group (p<0.05). Recurrent GPN was more common in the late AGPN group than the early AGPN group - 35.8% (n=24) versus 18.1% (n=15). Predictors for graft loss were assessed in patients with AGPN and the presence of renal abscess was predictive of graft loss in univariate analysis (HR-6.129, 95% CI 1.776–21.154, p-0.004). There were no significant predictors of mortality in univariate analysis. Kaplan Meier survival analysis showed decreased death censored graft survival in the early AGPN group (p-0.035). There was no Conclusion Occurrence of early AGPN had a significant impact on long term graft survival in renal transplant recipients with no significant effect on patient survival. This study underlines the paramount importance of the prevention of UTIs in renal transplant recipients.

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Haptoglobin Genotype Is Not Associated With Graft Loss, Cardiovascular or All-Cause Mortality in Renal Transplant Recipients.

Transplantation Journal ◽

10.1097/00007890-201407151-01931 ◽

2014 ◽

Vol 98 ◽

pp. 574

Author(s):

M. Svensson ◽

H. Krarup ◽

D. Dahle ◽

I. Eide ◽

J. Christensen ◽

...

Keyword(s):

Renal Transplant ◽

Graft Loss ◽

Renal Transplant Recipients ◽

Transplant Recipients ◽

Haptoglobin Genotype ◽

All Cause Mortality

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Post-transplantation plasma malondialdehyde is associated with cardiovascular mortality in renal transplant recipients: a prospective cohort study

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfz288 ◽

2020 ◽

Vol 35 (3) ◽

pp. 512-519 ◽

Cited By ~ 1

Author(s):

Manuela Yepes-Calderón ◽

Camilo G Sotomayor ◽

Rijk O B Gans ◽

Stefan P Berger ◽

Henri G D Leuvenink ◽

...

Keyword(s):

Ascorbic Acid ◽

Renal Function ◽

Renal Transplant ◽

Cardiovascular Mortality ◽

Graft Loss ◽

Renal Transplant Recipients ◽

Transplant Recipients ◽

Plasma Ascorbic Acid ◽

Targeted Interventions

Abstract Background In renal transplant recipients (RTRs), cardiovascular mortality is the most common cause of long-term renal graft loss. Oxidative stress (OS) has been associated with cardiovascular disease and is known to be enhanced in RTRs. We aimed to prospectively investigate whether the concentration of the OS biomarker malondialdehyde (MDA) is associated with long-term risk of cardiovascular mortality in a large cohort of RTRs. Methods The plasma MDA concentration was measured using the thiobarbituric acid reaction assay in 604 extensively phenotyped RTRs with a functioning allograft for ≥1 year. The association between MDA and cardiovascular mortality was assessed using Cox proportional hazard regression analyses in the overall cohort and within subgroups according to significant effect modifiers. Results Median circulating MDA concentration at baseline was 5.38 [interquartile range (IQR) 4.31–6.45] μmol/L. During a follow-up period of 6.4 (IQR 5.6–6.8) years, 110 (18%) RTRs died, with 40% of deaths due to cardiovascular causes. MDA concentration was significantly associated with the risk for cardiovascular mortality {hazard ratio [HR] 1.31 [95% confidence interval (CI) 1.03–1.67] per 1-SD increment}, independent of adjustment for potential confounders, including renal function, immunosuppressive therapy, smoking status and blood pressure. The association between MDA concentration and the risk for cardiovascular mortality was stronger in RTRs with relatively lower plasma ascorbic acid concentrations [≤42.5 µmol/L; HR 1.79 (95% CI 1.30–2.48) per 1-SD increment] or relatively lower estimated glomerular filtration rates [≤45 mL/min/1.73 m2; HR 2.09 (95% CI 1.45–3.00) per 1-SD increment]. Conclusions Circulating MDA concentration is independently associated with long-term risk for cardiovascular mortality, particularly in RTRs with relatively lower ascorbic acid concentrations or renal function. Further studies are warranted to elucidate whether OS-targeted interventions could decrease cardiovascular mortality in RTRs.

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Risk-Adjusted Analysis of Relevant Outcome Drivers for Patients after More Than Two Kidney Transplants

Journal of Transplantation ◽

10.1155/2015/712049 ◽

2015 ◽

Vol 2015 ◽

pp. 1-9 ◽

Cited By ~ 10

Author(s):

Lampros Kousoulas ◽

Florian W. R. Vondran ◽

Paulina Syryca ◽

Juergen Klempnauer ◽

Harald Schrem ◽

...

Keyword(s):

Renal Transplantation ◽

Graft Survival ◽

Patient Survival ◽

Therapeutic Option ◽

Graft Loss ◽

Renal Transplant Recipients ◽

Transplant Recipients ◽

Adjusted Analysis ◽

Stage Renal Disease ◽

End Stage

Renal transplantation is the treatment of choice for patients suffering end-stage renal disease, but as the long-term renal allograft survival is limited, most transplant recipients will face graft loss and will be considered for a retransplantation. The goal of this study was to evaluate the patient and graft survival of the 61 renal transplant recipients after second or subsequent renal transplantation, transplanted in our institution between 1990 and 2010, and to identify risk factors related to inferior outcomes. Actuarial patient survival was 98.3%, 94.8%, and 88.2% after one, three, and five years, respectively. Actuarial graft survival was 86.8%, 80%, and 78.1% after one, three, and five years, respectively. Risk-adjusted analysis revealed that only age at the time of last transplantation had a significant influence on patient survival, whereas graft survival was influenced by multiple immunological and surgical factors, such as the number of HLA mismatches, the type of immunosuppression, the number of surgical complications, need of reoperation, primary graft nonfunction, and acute rejection episodes. In conclusion, third and subsequent renal transplantation constitute a valid therapeutic option, but inferior outcomes should be expected among elderly patients, hyperimmunized recipients, and recipients with multiple operations at the site of last renal transplantation.

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P1767ERALY VERSUS LATE GRAFT PYELONEPHRITIS- A RETROSPECTIVE ANALYSIS OF GRAFT AND PATIENT OUTCOME

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p1767 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Anupma Kaul ◽

Thomas Mathews ◽

Dharmendra Bhaduria ◽

Narayan Prasad ◽

Amit Gupta

Keyword(s):

Renal Transplant ◽

Graft Survival ◽

Patient Survival ◽

Univariate Analysis ◽

Graft Loss ◽

Renal Transplant Recipients ◽

Transplant Recipients ◽

Significant Difference ◽

Dj Stent ◽

Baseline Characteristics

Abstract Background and Aims Acute graft pyelonephritis(AGPN) is thought to affect the graft and patient survival among the renal transplant recipients.Our objective was to compare these outcomes in those having early AGPN(<6 months from transplant) versus those having late AGPN(>6months from transpant) Method This retrospective study analysed 150 patients who had AGPN over a period of 8 years from 2005 to 2013.They were divided into early AGPN group and late AGPN group .Their baseline characteristics were compared.Predictors of graftloss and mortality were compared using logistic regression analysis.Graft survival and patient survival wereanalysed using Kaplan-Meyer survival plots Results A total of 150 patients with AGPN were analysed.Of these 55.3%(n=83) had early AGPN and 44.7%(n=67) had late AGPN.These two groups were comparable regarding baseline characteristics and immunosuppression.13.3%(n=11) patients in early AGPN group had CMV disease during follow up compared to 3%(n=2) in late AGPN group(p<0.05).26.5%(n=22) in the early AGPN group had prolonged foley’s catheterization(>5days) following transplant surgery compared to 7.5%(n=5) in late AGPN group(p<0.05).38.6%(n=32) in the early AGPN group had prolonged DJ stent in-situ(>2weeks) following transplant surgery compared to 19.4%(n=13) in the late AGPN group(p<0.05).Recurrent GPN was more common in the late AGPN group than the early AGPN group-35.8%(n=24) verus 18.1%(n=15).Predictors for graft loss was assessed in patients with AGPN and presence of renal abscess was predictive of graft loss in univariate analysis(HR-6.129 ,95 % CI 1.776-21.154,p-0.004).There were no significant predictors of mortality in univariateanalysis.KaplanMeiyer survival analysis showed decreased death censored graft survival in the early AGPN group(p-0.035).There was no significant difference in the patient survival among two groups. Conclusion Occurrence of early AGPN has significant impact on long term graft survival in renal transplant recipients with no significant effect on patient survival.This study underlines the paramount importance of prevention of UTIs in renal transplant recipients.

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High-Urgency Renal Transplantation: Indications and Long-Term Outcomes

Journal of Transplantation ◽

10.1155/2013/314239 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Lampros Kousoulas ◽

Nikos Emmanouilidis ◽

Wilfried Gwinner ◽

Jürgen Klempnauer ◽

Frank Lehner

Keyword(s):

Renal Transplantation ◽

Renal Transplant ◽

Graft Survival ◽

Survival Rates ◽

Renal Transplant Recipients ◽

Transplant Recipients ◽

Long Term Outcomes ◽

High Urgency ◽

Study Population

The concept of high-urgency (HU) renal transplantation was introduced in order to offer to patients, who are not able to undergo long-term dialysis treatment, a suitable renal graft in a short period of time, overcoming by this way the obstacle of the prolonged time spent on the waiting list. The goal of this study was to evaluate the patient and graft survivals after HU renal transplantation and compare them to the long-term outcomes of the non-high-urgency renal transplant recipients. The clinical course of 33 HU renal transplant recipients operated on at our center between 1995 and 2010 was retrospectively analyzed. The major indication for the HU renal transplantation was the imminent lack of access for either hemodialysis or peritoneal dialysis (67%). The patient survival of the study population was 67%, 56%, and 56%, whereas the graft survival was 47%, 35% and 35%, at 5, 10, and 15 years, respectively. In the comparison between our study population and the non-HU renal transplant recipients, our study population presented statistically significant(P<0.05)lower patient survival rates. The HU renal transplant recipients also presented lower graft survival rates, but statistical significance(P<0.05)was reached only in the 5-year graft survival rate.

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The Impact of Aorto-iliac Calcifications on Patient and Graft Survival in Renal Transplant Recipients Using the TASCII Classification

Transplantation Journal ◽

10.1097/01.tp.0000543412.26879.a6 ◽

2018 ◽

Vol 102 ◽

pp. S553

Author(s):

A.A. Rijkse ◽

H.J.A.N. Kimenai ◽

M.A. van der Zijden ◽

J.I. Roodnat ◽

S. Ten Raa ◽

...

Keyword(s):

Renal Transplant ◽

Graft Survival ◽

Renal Transplant Recipients ◽

Transplant Recipients ◽

The Impact ◽

Patient And Graft Survival

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Disassociation Between Risk of Graft Loss and Risk of Non-Hodgkin Lymphoma With Induction Agents in Renal Transplant Recipients

Transplantation Journal ◽

10.1097/01.tp.0000219817.18049.36 ◽

2006 ◽

Vol 81 (9) ◽

pp. 1227-1233 ◽

Cited By ~ 120

Author(s):

Gerhard Opelz ◽

Cord Naujokat ◽

Volker Daniel ◽

Peter Terness ◽

Bernd D??hler

Keyword(s):

Renal Transplant ◽

Hodgkin Lymphoma ◽

Graft Loss ◽

Renal Transplant Recipients ◽

Transplant Recipients ◽

Non Hodgkin Lymphoma ◽

Induction Agents

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Human BK Polyomavirus Nephropathy (BKVN) In Non- Kidney-Transplant Patients

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqaa161.258 ◽

2020 ◽

Vol 154 (Supplement_1) ◽

pp. S118-S118

Author(s):

Y Chen Wongworawat ◽

C Zuppan

Keyword(s):

Renal Transplant ◽

Kidney Transplant ◽

Graft Loss ◽

Renal Transplant Recipients ◽

Transplant Recipients ◽

Transplant Patients ◽

Bk Polyomavirus ◽

Pathologic Features ◽

Renal Biopsies ◽

Renal Transplant Patients

Abstract Introduction/Objective Human BK polyomavirus nephropathy (BKVN) occurs in up to 10% of renal transplant recipients, and can result in graft loss. Transplant biopsy is the gold standard to diagnose BKVN, and SV40 immunohistochemical (IHC) staining is helpful in confirming the diagnosis. BKVN is uncommon outside the setting of renal transplantation. To understand more about its occurrence in other contexts, we reviewed our renal biopsies files for cases of BKVN. Methods Our renal biopsy files for the past 20 years were reviewed for all cases with a diagnosis of BKVN or polyoma virus infection, and the clinical characteristics of the affected patients noted. Results Evidence of BKVN was found in 44 renal biopsies, of which 39 (86%) were renal transplant patients. Of the remaining five patients (14%), two had undergone heart transplantation, one lung transplantation, one was undergoing chemotherapy for acute lymphoblastic leukemia, and one patient had active HIV infection. All patients had elevated serum creatinine, and four out of five patients had documented BK viremia. Four of the five biopsies showed typical tubular injury with viral nuclear cytopathic changes (inclusions). In the lung transplant patient, the biopsy showed advanced chronic tubulointerstitial injury without distinct viral inclusions, but SV40 staining confirmed the presence of BK virus antigen. Conclusion The BKVN is distinctly uncommon outside the context of kidney transplantation. In our series, 14% of patients with BKVN were not kidney transplant recipients, but all were immune compromised in some fashion. The pathologic features of BKVN appear similar, regardless of whether the host is a renal transplant recipient or not. Although uncommon, it is important to consider the possibility of BKVN in non-renal transplant patients with persistent or progressive renal dysfunction.

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