Análisis de supervivencia del trasplante renal (cohorte retrospectiva)

Abstract

IntroductionKidney transplant is the treatment of choice for patients with end-stage renal disease. The present study describes the general characteristics of a cohort of renal transplant patients, and examines if there are differences in survival between subgroups. Materials and methodsThe follow-up records of post-kidney transplant patients between 1986 and 2015 were reviewed. The general characteristics and overall survival (Kapplan Meier) were defined; the subgroup differences were analysed in patients and graft survival by multiple Cox regression. The differences in the frequency of infections were defined by Odds Ratio. All statistical tests assumed 95% confidence limits. ResultsA total of 323 records from the follow up program for kidney transplant were reviewed. The mean age was 43years, and 63.5% were male. In the first year 19.8% had a urinary tract infection (UTI), and 10.53% cytomegalovirus (CMV), with 75.8% receiving alemtuzumab and the remainder thymoglobulin. The overall patient survival was 90.7%, and the overall graft survival was 90.4%. Survival was lower in patients with CMV infection, and graft survival was lower in patients treated with thymoglobulin (vs alemtuzumab). The remaining differences were not significant. ConclusionsCMV infection in the first year was associated with decreased patient survival. Alemtuzumab was associated with longer graft survival in our series. Double-blind randomised clinical trials are needed to establish causal associations, and to estimate the risk of graft loss and death in relation to UTI, as well as establishing homogeneous criteria for the definition of UTI.