TY - JOUR
T1 - Factors associated with primary and secondary graft failure following cadaveric kidney transplant
AU - Weiss-Salz, Inbal
AU - Mandel, Micha
AU - Galai, Noya
AU - Nave, Irit
AU - Boner, Geoffrey
AU - Mor, Eytan
AU - Nakache, Richard
AU - Simchen, Elisheva
AU - Ashkenazi, Tamar
AU - Boner, Geoffrey
AU - Eid, Ahmed
AU - Halevi, Jonathan
AU - Hoffman, Aaron
AU - Loewenthal, Ron
AU - Mizrahi, Solly
AU - Mor, Eytan
AU - Nakache, Richard
AU - Rahaminov, Ruth
AU - Rotem, Anat
AU - Shabtai, Moshe
PY - 2004/10
Y1 - 2004/10
N2 - The risk profile for primary renal graft failure is largely unknown because of its inclusion with secondary failures or its exclusion from analysis. This study compares characteristics of the cadaveric transplant recipients who experienced primary failure, secondary failures or survived with a functioning graft for at least 6 months. Medical records of all cadaveric kidney-transplant patients performed in Israel over a 3-yr period 1997-2000 were reviewed. Fisher's exact test and multinomial regression models were used to assess the association of demographic, pre-operative and operative risk factors with the two types of failure outcomes. Of 325 grafts, 54 (16.6%) failed of which half were primary failures. Univariate analysis demonstrated a significant trend of increasing proportion of patients with specific risk factors from the functioning grafts group to the secondary and to the primary graft failure groups. Independent risk factors for primary graft failure included 'surgical complications', 'donor's age ≥60 yr, 'waiting for transplant ≥6 yr', and 'human leukocyte antigen-DR (HLA-DR) mismatch', based on the multivariate model. These factors may reflect the scarcity of organ donations in Israel, which leads to a prolonged waiting time, higher tolerance for HLA-DR mismatches, and utilization of kidneys from elderly donors.
AB - The risk profile for primary renal graft failure is largely unknown because of its inclusion with secondary failures or its exclusion from analysis. This study compares characteristics of the cadaveric transplant recipients who experienced primary failure, secondary failures or survived with a functioning graft for at least 6 months. Medical records of all cadaveric kidney-transplant patients performed in Israel over a 3-yr period 1997-2000 were reviewed. Fisher's exact test and multinomial regression models were used to assess the association of demographic, pre-operative and operative risk factors with the two types of failure outcomes. Of 325 grafts, 54 (16.6%) failed of which half were primary failures. Univariate analysis demonstrated a significant trend of increasing proportion of patients with specific risk factors from the functioning grafts group to the secondary and to the primary graft failure groups. Independent risk factors for primary graft failure included 'surgical complications', 'donor's age ≥60 yr, 'waiting for transplant ≥6 yr', and 'human leukocyte antigen-DR (HLA-DR) mismatch', based on the multivariate model. These factors may reflect the scarcity of organ donations in Israel, which leads to a prolonged waiting time, higher tolerance for HLA-DR mismatches, and utilization of kidneys from elderly donors.
KW - Graft failure
KW - Kidney transplant
KW - Primary graft failure
KW - Secondary graft failure
UR - http://www.scopus.com/inward/record.url?scp=4644266302&partnerID=8YFLogxK
U2 - 10.1111/j.1399-0012.2004.00228.x
DO - 10.1111/j.1399-0012.2004.00228.x
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C2 - 15344962
AN - SCOPUS:4644266302
SN - 0902-0063
VL - 18
SP - 571
EP - 575
JO - Clinical Transplantation
JF - Clinical Transplantation
IS - 5
ER -