Factors associated with primary and secondary graft failure following cadaveric kidney transplant

Inbal Weiss-Salz, Micha Mandel, Noya Galai, Irit Nave, Geoffrey Boner, Eytan Mor, Richard Nakache, Elisheva Simchen, Tamar Ashkenazi, Geoffrey Boner, Ahmed Eid, Jonathan Halevi, Aaron Hoffman, Ron Loewenthal, Solly Mizrahi, Eytan Mor, Richard Nakache, Ruth Rahaminov, Anat Rotem, Moshe Shabtai

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

The risk profile for primary renal graft failure is largely unknown because of its inclusion with secondary failures or its exclusion from analysis. This study compares characteristics of the cadaveric transplant recipients who experienced primary failure, secondary failures or survived with a functioning graft for at least 6 months. Medical records of all cadaveric kidney-transplant patients performed in Israel over a 3-yr period 1997-2000 were reviewed. Fisher's exact test and multinomial regression models were used to assess the association of demographic, pre-operative and operative risk factors with the two types of failure outcomes. Of 325 grafts, 54 (16.6%) failed of which half were primary failures. Univariate analysis demonstrated a significant trend of increasing proportion of patients with specific risk factors from the functioning grafts group to the secondary and to the primary graft failure groups. Independent risk factors for primary graft failure included 'surgical complications', 'donor's age ≥60 yr, 'waiting for transplant ≥6 yr', and 'human leukocyte antigen-DR (HLA-DR) mismatch', based on the multivariate model. These factors may reflect the scarcity of organ donations in Israel, which leads to a prolonged waiting time, higher tolerance for HLA-DR mismatches, and utilization of kidneys from elderly donors.

Original languageEnglish (US)
Pages (from-to)571-575
Number of pages5
JournalClinical Transplantation
Volume18
Issue number5
DOIs
StatePublished - Oct 2004

Keywords

  • Graft failure
  • Kidney transplant
  • Primary graft failure
  • Secondary graft failure

ASJC Scopus subject areas

  • Transplantation

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