Back to Search
Start Over
Recipient Comorbidity and Survival Outcomes After Kidney Transplantation: A UK-wide Prospective Cohort Study
- Source :
- Transplantation. 104:1246-1255
- Publication Year :
- 2020
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2020.
-
Abstract
- Background Comorbidity is increasingly common in kidney transplant recipients, yet the implications for transplant outcomes are not fully understood. We analyzed the relationship between recipient comorbidity and survival outcomes in a UK-wide prospective cohort study-Access to Transplantation and Transplant Outcome Measures (ATTOM). Methods A total of 2100 adult kidney transplant recipients were recruited from all 23 UK transplant centers between 2011 and 2013. Data on 15 comorbidities were collected at the time of transplantation. Multivariable Cox regression models were used to analyze the relationship between comorbidity and 2-year graft survival, patient survival, and transplant survival (earliest of graft failure or patient death) for deceased-donor kidney transplant (DDKT) recipients (n = 1288) and living-donor kidney transplant (LDKT) recipients (n = 812). Results For DDKT recipients, peripheral vascular disease (hazard ratio [HR] 3.04, 95% confidence interval [CI]: 1.37-6.74; P = 0.006) and obesity (HR 2.27, 95% CI: 1.27-4.06; P = 0.006) were independent risk factors for graft loss, while heart failure (HR 3.77, 95% CI: 1.79-7.95; P = 0.0005), cerebrovascular disease (HR 3.45, 95% CI: 1.72-6.92; P = 0.0005), and chronic liver disease (HR 4.36, 95% CI: 1.29-14.71; P = 0.018) were associated with an increased risk of mortality. For LDKT recipients, heart failure (HR 3.83, 95% CI: 1.15-12.81; P = 0.029) and diabetes (HR 2.23, 95% CI: 1.03-4.81; P = 0.042) were associated with poorer transplant survival. Conclusions The key comorbidities that predict poorer 2-year survival outcomes after kidney transplantation have been identified in this large prospective cohort study. The findings will facilitate assessment of individual patient risks and evidence-based decision making.
- Subjects :
- Adult
Graft Rejection
Male
medicine.medical_specialty
Adolescent
Comorbidity
030230 surgery
Chronic liver disease
Risk Assessment
Young Adult
03 medical and health sciences
0302 clinical medicine
Risk Factors
Diabetes mellitus
Internal medicine
medicine
Humans
Obesity
Prospective Studies
Registries
Prospective cohort study
Kidney transplantation
Aged
Heart Failure
Peripheral Vascular Diseases
Transplantation
Proportional hazards model
business.industry
Liver Diseases
Graft Survival
Hazard ratio
Middle Aged
medicine.disease
QP
Kidney Transplantation
Transplant Recipients
United Kingdom
Cerebrovascular Disorders
Treatment Outcome
Chronic Disease
Kidney Failure, Chronic
Female
030211 gastroenterology & hepatology
business
RD
RC
Subjects
Details
- ISSN :
- 00411337
- Volume :
- 104
- Database :
- OpenAIRE
- Journal :
- Transplantation
- Accession number :
- edsair.doi.dedup.....8cd0efa7dc691144ead027744834fa66