TY - JOUR
T1 - Association of prevalent vascular disease with allograft failure and mortality in live-donor kidney transplant recipients – a retrospective cohort study
AU - Mainra, Rahul
AU - Wong, Germaine
AU - Pilmore, Helen
AU - Lim, Wai H.
PY - 2019/11/1
Y1 - 2019/11/1
N2 - Limited data exist regarding the impact of prevalent vascular disease after live-donor kidney transplantation. We aimed to determine the associations between the number of prevalent vascular diseases, allograft, and patient outcomes following live-donor transplantation. This cohort study used data from the Australia and New Zealand Dialysis and Transplant Registry. Rates between recipients of live-donor kidney transplants ± prevalent vascular disease prior to transplantation were calculated. The associations between vascular disease, allograft failure, and all-cause mortality were assessed using Cox regression modeling. Kaplan–Meier proportions were used to calculate all-cause mortality and death with a function graft stratified by vascular disease burden. Of 4742 live-donor recipients, 428 (9%) and 84 (2%) had prevalent vascular disease at 1 and ≥2 sites, respectively. Compared to recipients without vascular disease, the respective adjusted hazard ratios (95% confidence intervals) for patients with vascular disease at 1 and ≥2 sites were 1.78 (1.41–2.25) and 3.02 (2.03–4.50) for all-cause mortality; and 1.54 (1.26–1.88) and 2.28 (1.54–3.38) for allograft failure. All-cause mortality in recipients with vascular disease at 0, 1 and ≥2 sites was 0.028 (0.025, 0.031), 0.090 (0.073, 0.106) and 0.247 (0.196, 0.282) over the first 5-year post-transplant. There was an incremental association between the number of prevalent vascular disease sites and risk of allograft failure and all-cause mortality in live-donor kidney transplant recipients.
AB - Limited data exist regarding the impact of prevalent vascular disease after live-donor kidney transplantation. We aimed to determine the associations between the number of prevalent vascular diseases, allograft, and patient outcomes following live-donor transplantation. This cohort study used data from the Australia and New Zealand Dialysis and Transplant Registry. Rates between recipients of live-donor kidney transplants ± prevalent vascular disease prior to transplantation were calculated. The associations between vascular disease, allograft failure, and all-cause mortality were assessed using Cox regression modeling. Kaplan–Meier proportions were used to calculate all-cause mortality and death with a function graft stratified by vascular disease burden. Of 4742 live-donor recipients, 428 (9%) and 84 (2%) had prevalent vascular disease at 1 and ≥2 sites, respectively. Compared to recipients without vascular disease, the respective adjusted hazard ratios (95% confidence intervals) for patients with vascular disease at 1 and ≥2 sites were 1.78 (1.41–2.25) and 3.02 (2.03–4.50) for all-cause mortality; and 1.54 (1.26–1.88) and 2.28 (1.54–3.38) for allograft failure. All-cause mortality in recipients with vascular disease at 0, 1 and ≥2 sites was 0.028 (0.025, 0.031), 0.090 (0.073, 0.106) and 0.247 (0.196, 0.282) over the first 5-year post-transplant. There was an incremental association between the number of prevalent vascular disease sites and risk of allograft failure and all-cause mortality in live-donor kidney transplant recipients.
KW - all-cause mortality
KW - live-donor kidney transplantation
KW - vascular disease
UR - http://www.scopus.com/inward/record.url?scp=85068714158&partnerID=8YFLogxK
U2 - 10.1111/tri.13473
DO - 10.1111/tri.13473
M3 - Article
C2 - 31241216
AN - SCOPUS:85068714158
SN - 0934-0874
VL - 32
SP - 1161
EP - 1172
JO - Transplant International
JF - Transplant International
IS - 11
ER -