Analysis of 176 cases of death from kidney transplantation / 中华泌尿外科杂志

ABSTRACT

Objective To review the cadaveric kidney transplantations at our center in the past 22 years and to analyze the causes and the influencing factors on death in 176 patients who died after renal transplantation. Methods A total of 1 039 patients received cadaveric kidney graftings between October 1977 and June 1999.Patient's mortality was calculated by the Kaplan Meier method.The factors which might lead to patients' death,including age and sex of the donors and recipients,frequency of transplantation,dialysis time and transfusion volume before transplantation,cold ischemic time (CIT),delayed graft fuction (DGF),rejection,immunosuppressive regimen,and post transplant complications,were analyzed by log rank and Cox model. Results Total mortalities of the patient at 1 ,5 ,10 ,and 15 year were 6.9%,19.7%,32.1%,and 34.7%,respectively.The leading causes of patients' death were infection,cardiocerebral vascular diseases,and hepatic failure.The factors of transplant times,dialysis time before transplant,immunosuppressive regimen,chronic rejection,post transplant complications of pneumonitis and cardiocerebral vascular diseases were significant impact on transplant patient death by the analysis of Cox model. Conclusions In this series of 1039 cadaveric kidney transplant patients,the mortality since the first year after transplantation was increased annually by 2.5% during the past 22 years.The leading causes of patients' death are infection,cardiocerebral vascular diseases,and hepatic failure after renal transplantation.Transplant times in which patients receive the procedures,dialysis time before transplant,immunosuppressive regimen,chronic rejection,post transplant complications of pneumonitis and cardiocerebral vascular diseases are significant factors impacting on transplant patients' death.