移植技术与研究

Analysis of Factors Influencing on Living Kidney Donors and Deceased Kidney Donors Transplantation Results

Abstract

Rafał Kieszek, Kalina Jędrzejko, Piotr Domagała, Monika Bieniasz, Michał Wszoła, Aleksandra Tomaszek, Jolanta Gozdowska, Magdalena Durlik, Leszek Pączek, Andrzej Chmura and Artur Kwiatkowski

Introduction

Recognizing factors influencing kidney transplantation results may significantly affect therapeutic decisions made before, during and post transplantation.

Aim of the study

The aim of the study was to analyse factors influencing kidney graft function.

Material and methods

The group of 993 patients who received kidney graft from deceased and living donors, at Department of General and Transplantation Surgery, Baby Jesus Clinical Hospital in Warsaw, between January 1996 and August 2010 was analysed regarding factors that may have an influence on kidney transplantation results. Factors contingent from donor, recipient and time of kidney preservation were analysed.

Results

A multivariate analysis exhibited that time of dialyses prior transplantation is statistically significant factor influencing recipient’s survival (p=0.017). We proved that donor age is a variable that affects both recipient and graft survival. The higher number of mismatches HLA, the lower graft survival (p=0,0028). Cold ischaemia time (CIT) (OR=1.182), HBV infection (OR=1.58) as well as number of mismatch HLA (OR=1.1496), are the factors that influenced on frequency of delayed graft function (DGF) episodes. Moreover, we evidenced that the cause of graft failure affects graft survival. Patients, who suffer from IgA nephropathy, as well as hypertensive nephropathy, have the worst survival ratio after kidney transplantation. Patients who had had received a kidney graft from cadaveric donor with intracranial bleeding had higher creatinine serum concentration up to 5 years post transplantation in comparison with recipients whose kidney had come from donor with cranial trauma (p<0.005).

Conclusions

Factors that significantly influence on kidney graft function are: time of dialyses prior transplantation, number of mismatch HLA, cause of renal failure, HBV infection and CIT.