Multivariate analysis of factors affecting patient and graft survival after renal transplant.
OBJECTIVE
To evaluate factors affecting patient and kidney survival after renal transplant.


METHODS
Among 361 patients undergoing renal transplant: 52% (n = 189) were simultaneous with pancreas transplant (SPKT group) and 48% (n = 172), a kidney transplant alone (KT group). Out of 361 patients, 75% (n = 270) were diabetics. The patients were 220 (61%) men and 141 (39%) women of mean age 41 +/- 9 years. The mean time of dialysis was 42 +/- 21 months (range 0 to 126), and the mean duration of diabetes 24 +/- 7 years (range 5 to 51). A Cox regression analysis was done.


RESULTS
The multivariate analysis revealed that in the final model diabetes and donor age were significant predictors of kidney graft survival; moreover, diabetes and recipient age were predictors of patient survival. Overall patient survival was significantly greater among nondiabetic patients (P = .002) or in diabetic patients who received SPKT, when compared with diabetics in whom only the kidney was transplanted (P = .001).


CONCLUSIONS
Diabetes and donor age were independent prognostic factors affecting kidney graft survival after renal transplant, and recipient age and diabetes were prognostic factors affecting patient survival. Combined pancreas and kidney transplantation should be offered to patients with end-stage diabetic nephropathy.
Orsenigo
E
E
Department of Surgery, Vita e Salute University, San Raffaele Scientific Institute, Milan, Italy. orsenigo.elena@hsr.it
Socci
C
C
Carlucci
M
M
Zuber
V
V
Fiorina
P
P
Gavazzi
F
F
Secchi
A
A
Di Carlo
V
V
Staudacher
C
C
D000328:Adult; D002102:Cadaver; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery; D003928:Diabetic Nephropathies / Q000601:surgery; D005260:Female; D006085:Graft Survival / Q000502:physiology*; D006801:Humans; D016030:Kidney Transplantation / Q000502:physiology*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016035:Pancreas Transplantation / Q000502:physiology; D012044:Regression Analysis; D014019:Tissue Donors / Q000706:statistics & numerical data