Long-Term Outcomes in 831 Kidney Transplant Recipients with 20 Years of Graft Function

• DOI: 10.15342/ijms.2021.451
• Publication Date: 2021-04-07T19:42:54Z
• Authors: Varvara Kirchner; Kristen Gillingham; Oscar Serrano; Srinath Chinnakotla; Ty Dunn; Erik Finger; Raja Kandaswamy; Hassan Ibrahim; Richard Spong; William Payne; Timothy Pruett; David Sutherland; John Najarian; Arthur Matas
• Keywords: 03 medical and health sciences; 0302 clinical medicine; 3. Good health

An understanding of long-term outcomes for kidney transplant(KTx) recipients who survive with graft function beyond a specific time posttransplant is the first step in creating protocols to optimize care current and improve future recipients. We studied 831KTx recipients-580 living donor(LD); 251 deceased donor(DD)—with survival(GS) >20 years. For primary LD recipients, 25-year patient survival(PS) was 83%; 35-year, 59%. Their death-censored survival(DCGS) 89%; 72%. DD had lower PS(P<0.01), DCGS(P<0.01). After 20 years, two major causes loss(GL) were death function(DwF)(58%, LD; 58%, DD) interstitial fibrosis tubular atrophy(IFTA)(22%, 23%, DD). Two DwF cancer(31%, 31%, cardiovascular disease(CVD)(19%, LD;17%, Per multivariate analysis(MVA), risk factors GL after years pre–calcineurin inhibitor(CNI) era human leukocyte antigen(HLA) mismatches >3 antigens, pretransplant type 1 diabetes mellitus(DM1); CNI era, history rejection, female gender. New comorbidities common: CVD(13%, non-DM1;18%, DM1), infections(27%, non-DM1;37%, 20-29 posttransplant. Cancer included: nonmelanotic skin cancer,22%; solid organ,7%; post-transplant lymphoproliferative disease(PTLD),2%. To outcomes, clinical trials on prevention, recognition, treatment new are needed.