Kidney graft survival in Italy and factors influencing it.
OBJECTIVE
National registry data are often a suitable basis for examination of transplant outcomes. Using data supplied by the Italian National Transplant Registry, established in 1995, we performed the first nationwide analysis of this kind.


METHODS
A retrospective analysis of 4893 recipients of cadaveric kidneys transplanted in all Italian centers from 1995 through 2000 was done to study 5-year graft survival. The association between some donor and recipient variables and outcomes in renal transplantation was analyzed. Graft survival was 93% at 3 months, 89% at 1 year, 82% at 3 years, and 80% at 5 years after transplantation.


RESULTS
A significant association between graft survival and donor age (old vs young, relative risk [RR] = 1.62, 95% CI 1.27-2.06) and recipient age (old vs young, RR = 1.25, 95% CI 1.02-1.53). Graft survival was also associated with cold ischemia time (24-36 hours, RR= 1.39, 95% CI 1.05-1.85 and >36 hours, RR= 1.94, 95% CI 1.32-2.86 vs 0-24 hours) and donor/recipient sex mismatch (female/male vs male/male, RR= 1.50, 95% CI 1.17-1.93).


CONCLUSIONS
The quality of kidney transplantation in Italy is satisfactory and is comparable to that in other developed countries. Furthermore, our experience confirms that both donor and recipient factors are major determinants of renal allograft function.
Pugliese
Orsola
O
Department of Infectious, Parasitic, and Immunomediated Diseases, National Institute of Health, Rome, Italy.
Quintieri
Francesca
F
Mattucci
Dino Alberto
DA
Venettoni
Sante
S
Taioli
Emanuela
E
Costa
Alessandro Nanni
AN
D000328:Adult; D000368:Aged; D005260:Female; D006085:Graft Survival; D006801:Humans; D007558:Italy; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009926:Organ Preservation; D017063:Outcome Assessment, Health Care; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D009927:Tissue and Organ Procurement