TY - JOUR
T1 - Causas de muerte en pacientes con un injerto renal funcionante. ¿Han ocurrido cambios en las últimas décadas?
AU - Vega, Jorge
AU - Videla, Christian
AU - Borja, Hernán
AU - Goecke, Helmuth
AU - Martínez, Felipe
AU - Betancour, Pablo
N1 - Funding Information:
Funding: this work was supported in part by: Fondazione Telethon Grant n° GGP15064 to Laura Silvestri; ANR-16-ACHN-0002-01 and by European Research Council grant 715491 to Léon Kautz; the Telethon SR-TIGET Core Grant to Giuliana Ferrari; the National Health and Medical Research Council, Australia, Early Career Fellowship GNT1035339 to Sant-Rayn Pasricha. Antonella Nai was supported by the European Hematology Association Josè-Carreras Junior Research fellowship. Correspondence: LAURA SILVESTRI - [email protected] doi:10.3324/haematol.2018.199810 Information on authorship, contributions, and financial & other disclosures was provided by the authors and is available with the online version of this article at www.haematologica.org.
PY - 2012/3/1
Y1 - 2012/3/1
N2 - Background: Death with a functioning graft(DWGF) is now one of the main causes of renal transplant (RTx) loss. Aim: To determine whether the causes of DWGF, characteristics of donors and recipients and complications of RTx have changed in the last two decades. Subjects and Methods: Cooperative study of a cohort of 418 kidney grafts performed between 1968 and 2010. Patients were divided into two groups according to whether their kidney transplants were performed between 1968 and 1992 (Group 1) or 1993 and 2010 (Group 2). Results: Sixty eight patients experienced DWGF. Infections were the leading cause of DWGF in both groups (38 and 41%, respectively), followed by cardiovascular diseases (24 and 23% respectively), gastrointestinal disorders (21 and 26% respectively) and cancer (17 and 10% respectively). There were no significant differences in causes of death between the two groups according to the time elapsed since the renal transplantation. In patients in Group 1, the interval between diagnosis of renal failure and dialysis (HD) and the interval between the start of HD and kidney transplantation were significantly lower than in Group 2. The former had also an increased number of acute rejections in the first five years of kidney transplantation (p < 0.001). In Group 2, patients more often received their kidneys from deceased donors, had previous kidney transplantation, higher rate of antibodies to a panel of lymphocytes and an increased incidence of cardiovascular disorders after five years of RTx. Conclusions: The proportion of graftloss due to DWGF has increased over the last 2 decades, but its causes have not changed significantly. Infections are the most common causes of DWGF followed by cardiovascular and digestive diseases.
AB - Background: Death with a functioning graft(DWGF) is now one of the main causes of renal transplant (RTx) loss. Aim: To determine whether the causes of DWGF, characteristics of donors and recipients and complications of RTx have changed in the last two decades. Subjects and Methods: Cooperative study of a cohort of 418 kidney grafts performed between 1968 and 2010. Patients were divided into two groups according to whether their kidney transplants were performed between 1968 and 1992 (Group 1) or 1993 and 2010 (Group 2). Results: Sixty eight patients experienced DWGF. Infections were the leading cause of DWGF in both groups (38 and 41%, respectively), followed by cardiovascular diseases (24 and 23% respectively), gastrointestinal disorders (21 and 26% respectively) and cancer (17 and 10% respectively). There were no significant differences in causes of death between the two groups according to the time elapsed since the renal transplantation. In patients in Group 1, the interval between diagnosis of renal failure and dialysis (HD) and the interval between the start of HD and kidney transplantation were significantly lower than in Group 2. The former had also an increased number of acute rejections in the first five years of kidney transplantation (p < 0.001). In Group 2, patients more often received their kidneys from deceased donors, had previous kidney transplantation, higher rate of antibodies to a panel of lymphocytes and an increased incidence of cardiovascular disorders after five years of RTx. Conclusions: The proportion of graftloss due to DWGF has increased over the last 2 decades, but its causes have not changed significantly. Infections are the most common causes of DWGF followed by cardiovascular and digestive diseases.
KW - Immunosuppressive agents
KW - Kidney transplantation
KW - Morbidity
KW - Mortality
KW - Prognosis
KW - Treatment outcome
UR - http://www.scopus.com/inward/record.url?scp=84862141997&partnerID=8YFLogxK
U2 - 10.4067/S0034-98872012000300003
DO - 10.4067/S0034-98872012000300003
M3 - Artículo
C2 - 22689108
AN - SCOPUS:84862141997
SN - 0034-9887
VL - 140
SP - 295
EP - 304
JO - Revista Medica de Chile
JF - Revista Medica de Chile
IS - 3
ER -