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Association between age and graft failure rates in young kidney transplant recipients.
- Source :
-
Transplantation [Transplantation] 2011 Dec 15; Vol. 92 (11), pp. 1237-43. - Publication Year :
- 2011
-
Abstract
- Background: Age at transplant and graft failure risk are associated in young kidney transplant recipients. The risk of graft failure may also vary by current age, irrespective of age at transplant. We sought to estimate age-specific graft failure rates in young kidney transplant recipients and to estimate the relative hazards of graft failure at different ages, compared with at the age of 25 to 29 years.<br />Methods: We evaluated 90,689 patients recorded in the United States Renal Data System database who received a first transplant when younger than 40 years (1988-2009); 18,310 were younger than 21 years at transplant. Time-dependent Cox models with time-varying covariates were used to estimate the association between age (time-dependent) and death-censored graft failure risk, adjusted for time since transplant and other potential confounders.<br />Results: There were 31,857 graft failures over a median follow-up of 5.9 years (interquartile range, 2.5-10.5 years; maximum, 21.8 years). Crude age-specific graft failure rates were highest in 19 year olds (6.6 per 100 person-years). Compared with individuals with the same time since transplant observed at 25 to 29 years of age, death-censored graft failure rates were highest in 17 to 24 year olds (hazard ratio, 1.20; [95% confidence interval 1.13, 1.27] for 17-20 year olds and 1.20 [1.13, 1.26] for 21-24 year olds; both P<0.0001) and lowest in 5 to 12 year olds (hazard ratio, 0.60; [0.53, 0.68] for 5-9 year olds and 0.56 [0.49, 0.64] for 10-12 year olds; both P<0.0001).<br />Conclusion: Among first kidney transplant recipients younger than 40 years, older adolescents and young adults (17-24 years) have the highest risk of graft failure, irrespective of age at transplant.
- Subjects :
- Adolescent
Adult
Age Factors
Child
Child, Preschool
Cohort Studies
Female
Follow-Up Studies
Graft Survival physiology
Humans
Infant
Infant, Newborn
Kidney Transplantation statistics & numerical data
Male
Multivariate Analysis
Retrospective Studies
Risk Factors
Time Factors
United States
Young Adult
Aging physiology
Graft Rejection epidemiology
Graft Rejection physiopathology
Kidney Transplantation physiology
Transplantation physiology
Subjects
Details
- Language :
- English
- ISSN :
- 1534-6080
- Volume :
- 92
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 22124283
- Full Text :
- https://doi.org/10.1097/TP.0b013e31823411d7