Predictors of Early Graft Loss Confirmed

SAN DIEGO—Researchers who studied pairs of renal transplant recipients who received kidneys from the same donor have confirmed previously identified recipient risk factors for early renal graft loss, according to a report presented at Kidney Week 2012.

The report detailed a study in which investigators analyzed outcomes of donor-matched recipient pairs with discrepant graft survival: one graft surviving less than two years (early graft loss) and the other surviving at least 7.5 years (late graft loss).

In this way, the researchers could determine predictors of early graft loss while controlling for donor factors. Using the United Network for Organ Sharing database, Joyce P. Samuel, MD, of the University of Texas Medical School at Houston, and colleagues identified 4,630 patients with discrepant graft survival who received a kidney from 2,315 deceased donors.

Compared with late graft loss, the risk of early graft loss was increased by 68% if the recipient was black. The likelihood of early graft loss was 40% less likely in those recipients who had never before received a kidney transplant compared with those who had. The risk of early graft loss increased with increasing body mass index, age, and cold ischemia time. Higher antibody sensitization also predicted early graft loss. Recipient gender, dialysis prior to transplant, and time on the transplant waiting list were not associated with an increased risk of early graft loss.

The median graft survival was five months among patients with early graft loss group compared with 122 months among those with late graft loss.

“This analysis utilized a unique study design to reiterate the risk for adverse graft outcome associated with various recipient characteristics,” Dr. Samuel told Renal & Urology News. “The most important implication is that certain modifiable risk factors—recipient body mass index, antibody sensitization—remain important predictors of graft outcome.”

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