Recipient Related Prognostic Factors for Graft Survival after Kidney Transplantation. A Single Center Experience

Abstract

Background and Aim. Advanced chronic kidney disease (CKD) severely impairs life expectancy and quality of life in affected patients. Considering its benefits, renal transplantation currently represents the optimal treatment solution for end stage kidney disease patients. Pre-transplant assessment aims to maximize the graft and patient survival by identifying potential factors influencing the post-transplant outcome. The aim of this study has been to analyze recipient related prognostic factors bearing an impact on graft survival. Material and Methods. We analyzed the graft outcomes of 426 renal transplantations performed at the Clinical Institute of Urology and Renal Transplantation of Cluj-Napoca, between January 2004 and December 2008. Variables related to recipient and to potential donor/recipient prognostic factors were studied using univariate and multivariate analysis. Results. Graft survivals at 1, 3, 5 and 7 years were 94.01%, 88.37%, 82.51% and 78.10%, respectively. Chronic rejection (41.11%) and death with a functioning graft (18.88%) were the main causes of graft loss. In uni and multivariate analysis the recipient related variables found to influence the renal graft outcome were: peritoneal dialysis, pre transplant residual diuresis, grade I hypertension, severe iliac vessel atheromatosis, ischemic heart disease, stroke history, dyslipidemia and denutrition. The worst graft outcomes have been found for recipients on peritoneal dialysis, with anuria, hypotension, severe iliac atheromatosis, ischemic heart disease, stroke history, dyslipidemia and a poor nutritional status. Conclusion. The type of dialysis, the pre transplant residual diuresis, recipient arterial blood pressure, iliac vessel atheromatosis, ischemic heart disease, stroke history, dyslipidemia and denutrition significantly influence graft survival.