Open AccessEarly renal function recovery and long‐term graft survival in kidney transplantation
Author(s) -
Wan Susan S.,
Cantarovich Marcelo,
Mucsi Istvan,
Baran Dana,
Paraskevas Steven,
Tchervenkov Jean
Publication year - 2016
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/tri.12775
Subject(s) - medicine , kidney transplantation , urology , transplantation , renal function , cohort , surgery , oncology
Summary Following kidney transplantation ( KT x), renal function improves gradually until a baseline eGFR is achieved. Whether or not a recipient achieves the best‐predicted eGFR after KT x may have important implications for immediate patient management, as well as for long‐term graft survival. The aim of this cohort study was to calculate the renal function recovery ( RFR ) based on recipient and donor eGFR and to evaluate the association between RFR and long‐term death‐censored graft failure ( DCGF ). We studied 790 KT x recipients between January 1990 and August 2014. The last donor SC r prior to organ procurement was used to estimate donor GFR . Recipient eGFR was calculated using the average of the best three SC r values observed during the first 3 months post‐ KT x. RFR was defined as the ratio of recipient eGFR to half the donor eGFR . 53% of recipients had an RFR ≥1. There were 127 death‐censored graft failures (16%). Recipients with an RFR ≥1 had less DCGF compared with those with an RFR <1 ( HR 0.56; 95% CI 0.37–0.85; P = 0.006). Transplant era, acute rejection, ECD and DGF were also significant determinants of graft failure. Early recovery of predicted eGFR based on donor eGFR is associated with less DCGF after KTx.