title: Risk factors for long-term graft loss in kidney transplantation: experience of a Mexican single-center.
abstract: OBJECTIVE
  There is not enough information regarding risk factors for renal graft loss in Mexico and Latin America. The aim of this study was to analyze risk factors associated with graft loss in our renal transplant (RT) population.
  
  
  METHODS
  Clinical records of 326 patients with a first RT performed between August/76 and June/99 were reviewed. Clinical and laboratory variables were recorded, as well as the final patient and renal function status.
  
  
  METHODS
  Survival analysis by Kaplan-Meier method; mortality risk by multivariate Cox's proportional hazard model.
  
  
  RESULTS
  At the end of the study, 275 patients were alive, 30 were dead, 21 lost to follow-up; 65 patients (20%) had reinitiated dialysis. Patient survival at 1, 3, 5, 8, and 10 years was 92%, 86%, 81%, 77%, and 77%, respectively. Graft survival at 1, 3, 5, 8, and 10 years was 87%, 73%, 64%, 50%, and 47%, respectively. In the univariate analysis, the following were significantly associated (p < 0.05) with graft loss: acute rejection episodes, cadaveric donors, and HLA haplotype mismatches. In the multivariate analysis, only acute rejection (RR 2.12, p = 0.002) and a lower HLA haplotype matching (RR 0.37, p = 0.002) predicted graft loss.
  
  
  CONCLUSIONS
  In Mexican population, graft survival was similar to the reported in developed countries. The main risk factors for long-term graft failure were acute rejection and HLA haplotype mismatching.
authors.affiliation: Unit of Medical Research in Clinical Epidemiology, Hospital de Especialidades, CMNO, IMSS, Guadalajara, Mexico.
authors.forename: Alfonso M
authors.initials: AM
authors.lastname: Cueto-Manzano
authors.forename: Enrique
authors.initials: E
authors.lastname: Rojas
authors.forename: Guillermo
authors.initials: G
authors.lastname: Rosales
authors.forename: Benjamín
authors.initials: B
authors.lastname: Gómez
authors.forename: Héctor Ramón
authors.initials: HR
authors.lastname: Martínez
authors.forename: Laura
authors.initials: L
authors.lastname: Cortés-Sanabria
authors.forename: Antonio
authors.initials: A
authors.lastname: Flores
authors.forename: Salvador
authors.initials: S
authors.lastname: Chávez
authors.forename: J Luis
authors.initials: JL
authors.lastname: Camarena
authors.forename: Francisco
authors.initials: F
authors.lastname: González
authors.forename: Graciela
authors.initials: G
authors.lastname: Paredes
authors.forename: Mario
authors.initials: M
authors.lastname: Sandoval
authors.forename: Carlos
authors.initials: C
authors.lastname: Valdespino
authors.forename: Florencio
authors.initials: F
authors.lastname: Gutiérrez
authors.forename: Francisco
authors.initials: F
authors.lastname: Monteón
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D015331:Cohort Studies; D005260:Female; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000401:mortality*; D008297:Male; D008800:Mexico; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors