چکیده
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Despite several studies conducted to detect predisposing factors of graft rejection,
results are inconsistent and limited. This study was performed to estimate long-term
survival rate of kidney transplantation and to detect associated prognostic factors.
Material/Methods: This retrospective cohort study was conducted in Hamadan Province, in western
Iran, enrolling 475 patients who had undergone kidney transplantation from 1994 to
2011. Data were extracted from patients’ medical records using a checklist. Chronic
nonreversible graft rejection was considered as the event of interest. The duration
of time between kidney transplantation and rejection was considered as the survival
time. Life table, Kaplan-Meier curve, log-rank test and Cox proportional hazard
model were used for data analysis.
Results: Out of 475 transplantations, 55 episodes of rejection occurred. One-, 5-, 10-, 15-,
and 18-year survival rates of transplantation were 97.1%, 92.3%, 86.2%, 77.6%, and
60.3%, respectively. The hazard ratio of graft rejection per 1-year increase in recipient
age was 0.92 (P=0.001). The hazard ratio of graft rejection was 5.47 for grafts
from deceased donors compared to grafts from living donors (P=0.025), and 3.54
(P=0.025) and 47.99 (P=0.001) in patients with episode of acute and hyperacute rejection
compared to those without rejection episode, respectively.
Conclusions: Rejection of kidney transplantation is shaped by several prognostic factors, the most
important of which are recipient age, type of donor (living vs. deceased), and episode
of post-transplantation acute and hyperacute rejection
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