Iranian model of renal allograft transplantation in 3028 recipients: survival and risk factors.
BACKGROUND
Considering the organ shortage crisis for renal transplantation worldwide, assessing the risk factors to establish better allocation strategies to improve graft survival seems to be crucial.


OBJECTIVE
We aimed to evaluate the risk factors influencing graft and patient survival after renal transplantation to construct a model of prognostic factors for living renal transplantation (LRT), namely living unrelated renal transplantation (LURT).


METHODS
We designed a retrospective multicenter survey including medical record review of 3028 patients who received renal transplants at 2 hospitals between July 1984 and December 2005. We assessed the impact on graft survival of recipient/donor relationship, recipient age and gender, donor age and gender, and viral hepatitis B and C infections.


RESULTS
Among 3028 recipients, including 94.8% primary grafts, 63.4% were men, mean +/- SE of age 36.4 +/- 0.3 years, with mostly end-stage renal disease due to diabetes mellitus, hypertension, or glomerulonephritis. One-, 5-, 10- and 15-year graft survival rates were 85.4%, 68.3%, 46.4%, and 23.8%, respectively. Patient survival rates were 93.4%, 87.5%, 79.4%, and 66.4% at the above intervals, respectively. Donor age (relative hazard [RH], 1.024; P<.001), unrelated donors (RH, 1.7; P<.001), and hepatitis C virus (HCV) infection (RH, 2.65; P<.001) were the only significant factors affecting graft survival.


CONCLUSIONS
Increased donor age, unrelated donor, and HCV infection were significant factors negatively impacting graft survival; thus, proper management of these factors may lead to better graft and patient survival.
Einollahi
B
B
Nephrology and Urology Research Center, and Department of Internal Medicine, Baqyiatallah University of Medical Sciences, Tehran, Iran. beinollahi@yahoo.com
Pourfarziani
V
V
Ahmadzad-Asl
M
M
Davoudi
F
F
Lessan-Pezeshki
M
M
Davoudi
A
A
Nourbala
A
A
Shariat-Moghani
S
S
Nemati
E
E
Poor-Reza-Gholi
F F
FF
Simforoosh
N
N
D000367:Age Factors; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007492:Iran; D016030:Kidney Transplantation / Q000401:mortality* / Q000502:physiology*; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors; D014184:Transplantation, Homologous