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Role of pre‐transplant marital status in renal transplant outcome
Author(s) -
Naiman Natalie,
Baird Bradley C.,
Isaacs Ross B.,
Koford James K.,
Habib Arsalan N.,
Wang Benjr,
Barenbaum Lev L.,
GoldfarbRumyantzev Alexander S.
Publication year - 2007
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2006.00575.x
Subject(s) - medicine , hazard ratio , confounding , proportional hazards model , marital status , survival analysis , kidney transplantation , transplantation , subgroup analysis , kidney , confidence interval , population , environmental health
Background: End‐stage renal disease is associated with illness‐induced disruptions that challenge patients and their families to accommodate and adapt. However, the impact of patients’ marital status on kidney transplant outcome has never been studied. This project, based on data from United States Renal Data System (USRDS), helps to answer how marriage affects renal transplant outcome. Methods: Data have been collected from USRDS on all kidney/kidney‐pancreas allograft recipients between January 1, 1995 and June 30, 2002, who were 18 yr old or older and had information about their marital status prior to the kidney transplantation (n = 2061). Survival analysis was performed using Kaplan–Meier methods and Cox proportional hazards modeling to control for confounding variables. Results: Overall findings of this study suggest that being married has a significant protective effect on death‐censored graft survival [Hazard Ratio (HR) 0.80, p < 0.05] but a non‐significant effect on recipient survival (HR 0.85, p = 0.122). When stratified by gender, the effect was still present in males for death‐censored graft survival (HR 0.75, p < 0.05), but not for recipient survival (HR 0.86, p = 0.24). The effect was not observed in females, where neither graft (HR 0.90, p = 0.55) nor recipient (HR 0.8, p = 0.198) survival had an association with marital status. In subgroup analysis similar association was found in the recipients of a single transplant. Conclusion: Based on our analysis, being married in the pre‐transplant period is associated with positive outcome for the graft, but not for the recipient survival. When analyzed separately, the effect is present in male, but not in female recipients.