Outcomes in kidney transplantation with mycophenolate mofetil-based maintenance immunosuppression in China: a large-sample retrospective analysis of a national database.

Abstract

There is no large data analysis reporting the outcome of Chinese kidney transplant patients using mycophenolate mofetil (MMF). This study analyzed 6719 patients from the Chinese Scientific Registry of Kidney Transplantation using MMF, which included 1153 from donation after cardiac death (DCD), 1271 from donation after brain and cardiac death (DBCD), and 4295 from living donor (LD). Compared with the transplants from deceased donor (DD), better outcomes including 3-year graft survival probabilities (LD=95.8% vs. DD=91.3%), incidence of delayed graft function (DGF, LD=2.4% vs. DD=17.7%), infection (LD=10.7% vs. DD=20.7%), graft loss (LD=2.3% vs. DD=6.3), and death (LD=1.3% vs. DD=3.2%) were shown in the LD group, with similar incidences of acute rejection (AR, LD=3.7% vs. DD=4.7%), hyperuricemia (LD=21.7% vs. DD=22.2%) within postoperative 1year, and serum creatinine (Scr) >133μmol/l at 1year (LD=18.8% vs. DD=18.6%). Nonsignificant differences were found between the DCD and DBCD group. The 5-year survival of patient and graft in the LD group were 97.5% and 93.0%. Adjusted Cox model for graft loss showed significant associations with DGF [hazard ratio 3.7 (95% CI: 2.4, 5.8)], AR [2.8 (1.7, 4.6)], Scr >133μmol/l at 1year [2.6 (1.5, 4.2)], hyperuricemia [2.3 (1.6, 3.3)], and DD [1.6 (1.1, 2.4)].