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Evolution of kidney allograft loss causes over 40 years (1979-2019)

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dc.contributor.author Redondo Pachón, María Dolores
dc.contributor.author Calatayud, Emma
dc.contributor.author Buxeda, Anna
dc.contributor.author Pérez-Sáez, María José
dc.contributor.author Arias Cabrales, Carlos Enrique
dc.contributor.author Gimeno Beltran, Javier
dc.contributor.author Burballa Tàrrega, Carla, 1988-
dc.contributor.author Mir, Marisa
dc.contributor.author Llinàs-Mallol, Laura
dc.contributor.author Outón González, Sara
dc.contributor.author Pascual Santos, Julio
dc.contributor.author Crespo Barrio, Marta
dc.date.accessioned 2024-05-09T06:22:59Z
dc.date.available 2024-05-09T06:22:59Z
dc.date.issued 2023
dc.identifier.citation Redondo-Pachón D, Calatayud E, Buxeda A, Pérez-Sáez MJ, Arias-Cabrales C, Gimeno J, et al. Evolution of kidney allograft loss causes over 40 years (1979-2019). Nefrologia (Engl Ed). 2023 May-Jun;43(3):316-27. DOI: 10.1016/j.nefroe.2023.07.003
dc.identifier.issn 2013-2514
dc.identifier.uri http://hdl.handle.net/10230/60080
dc.description Article disponible en castellà: http://hdl.handle.net/10230/60085
dc.description.abstract Introduction: The improvement of kidney allograft recipient and graft survival showed a decrease over the last 40 years. Long-term graft loss rate remained stable during a 25-year time span. Knowing the changing causes and the risk factors associated with graft loss requires special attention. The present study aimed to assess the causes of graft loss and kidney allograft recipient death. Also, we aimed to compare two different periods (1979-1999 and 2000-2019) to identify changes in the characteristics of the failed allografts and recipient and donors profile. Methods and patients: We performed a single-center cohort study. We included all the kidney transplant recipients at the Hospital del Mar (Barcelona) between May 1979 and December 2019. Graft loss was defined as recipient death with functioning graft and as loss of graft function (return to dialysis or retransplantation). We assessed the causes of graft loss using clinical and histological information. We also analyzed the results of the two different transplant periods (1979-1999 and 2000-2019). Results: Between 1979 and 2019, 1522 transplants were performed. The median follow-up time was 56 (IQR 8-123) months. During follow-up, 722 (47.5%) grafts were lost: 483 (66.9%) due to graft failure and 239 (33.1%) due to death with functioning graft. The main causes of death were cardiovascular (25.1%), neoplasms (25.1%), and infectious diseases (21.8%). These causes were stable between the two periods of time. Only the unknown cause of death has decreased in the last period. The main cause of graft failure (loss of graft function) was the allograft chronic dysfunction (75%). When histologic information was available, antibody-mediated rejection (ABMR) and interstitial fibrosis/tubular atrophy (IF/TA) were the most frequent specific causes (15.9% and 12.6%). Of the graft failures, 213 (29.5%) were early (<1 year of transplantation). Vascular thrombosis was the main cause of early graft failure in the second period (2000-2019) (46.7%) and T-cell-mediated rejection (TCMR) was the main cause (31.3%) in the first period (1979-1999). The causes of late graft loss were similar between the two periods. Conclusions: The causes of kidney allograft recipient death are still due to cardiovascular and malignant diseases. Vascular thrombosis has emerged as a frequent cause of early graft loss in the most recent years. The evaluation of the causes of graft loss is necessary to improve kidney transplantation outcomes.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher Elsevier
dc.relation.ispartof Nefrologia (Engl Ed). 2023 May-Jun;43(3):316-27
dc.rights © 2021 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.title Evolution of kidney allograft loss causes over 40 years (1979-2019)
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1016/j.nefroe.2023.07.003
dc.subject.keyword Graft failure
dc.subject.keyword Kidney transplantation
dc.subject.keyword Graft survival
dc.subject.keyword Patient survival
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/publishedVersion

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