TY - JOUR
T1 - Five preventable causes of kidney graft loss in the 1990s
T2 - A single-center analysis
AU - Matas, Arthur J.
AU - Humar, Abhinav
AU - Gillingham, Kristen J.
AU - Payne, William D.
AU - Gruessner, Rainer W.G.
AU - Kandaswamy, Raja
AU - Dunn, David L.
AU - Najarian, John S.
AU - Sutherland, David E.R.
N1 - Funding Information: This study was supported by the National Institutes of Health grant #13083. We thank Ms. Mary Knatterud for editorial assistance and Ms. Stephanie Daily for preparation of the manuscript.
PY - 2002
Y1 - 2002
N2 - Background. Despite improvements in immunosuppressive protocols and patient care, kidney allografts continue to fail. We studied causes of graft loss for primary kidney transplants in the 1990s to determine major causes and potential interventions. Methods. Causes of graft loss were reviewed for 1467 primary kidney transplants done at our institution between January 1, 1990, and December 31, 1999. Graft loss for that entire population was studied and then the causes of loss selectively examined at <1 year, 1 to 5 years, and >5 years post-transplant. Finally, causes of loss in the 1990s versus the 1980s were compared. Results. Five major causes of graft loss were noted in the 1990s: thrombosis, acute rejection (either alone or combined with delayed graft function or infection), chronic rejection, death with function, and noncompliance. In the first year post-transplant, thrombosis (25%) and death with function (41%) were the major causes of graft loss. After the first year, chronic rejection and death with function predominated. For recipients dying with graft function, cardiovascular disease was the major cause of death. Conclusions. This study identified the five major causes of kidney graft loss in the 1990s. Different interventions are required to decrease loss from each of these causes. Future research needs to be directed at such interventions.
AB - Background. Despite improvements in immunosuppressive protocols and patient care, kidney allografts continue to fail. We studied causes of graft loss for primary kidney transplants in the 1990s to determine major causes and potential interventions. Methods. Causes of graft loss were reviewed for 1467 primary kidney transplants done at our institution between January 1, 1990, and December 31, 1999. Graft loss for that entire population was studied and then the causes of loss selectively examined at <1 year, 1 to 5 years, and >5 years post-transplant. Finally, causes of loss in the 1990s versus the 1980s were compared. Results. Five major causes of graft loss were noted in the 1990s: thrombosis, acute rejection (either alone or combined with delayed graft function or infection), chronic rejection, death with function, and noncompliance. In the first year post-transplant, thrombosis (25%) and death with function (41%) were the major causes of graft loss. After the first year, chronic rejection and death with function predominated. For recipients dying with graft function, cardiovascular disease was the major cause of death. Conclusions. This study identified the five major causes of kidney graft loss in the 1990s. Different interventions are required to decrease loss from each of these causes. Future research needs to be directed at such interventions.
KW - Allograft
KW - Chronic rejection
KW - Delayed graft function
KW - Kidney graft
KW - Organ rejection
KW - Thrombosis
KW - Transplantation
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U2 - 10.1046/j.1523-1755.2002.00491.x
DO - 10.1046/j.1523-1755.2002.00491.x
M3 - Article
C2 - 12110036
SN - 0085-2538
VL - 62
SP - 704
EP - 714
JO - Kidney International
JF - Kidney International
IS - 2
ER -