Influence of early graft function after renal transplantation and its impact on long-term graft and patient survival.
OBJECTIVE
To determine whether early graft function after transplantation impacted graft and patient survivals.


METHODS
Between 1981 and 2008, we performed 1308 renal transplantations. Poor early graft function was defined as a Cockroft-Gault glomerular filtration rate<60 mL/min or less at 1 and 3 months posttransplant. Patients who lost their kidney or died within the first 12 months after transplantation were excluded from the study. Multivariate statistical analysis used Cox proportional hazards models.


RESULTS
Of the 1308 patients 994 (78.8%) displayed poor early graft function at 1 month after transplantation (glomerular filtration rate<60 mL/min), while 268 (21.2%) showed normal function (glomerular filtration rate≥60 mL/min). The 2- and 6-year graft survival rates among the poor early graft function group were 96.8% and 85.8%, respectively, while those among the control group were 97.0% and 88.3%, respectively. The 2- and 6-year patient survival rates in the poor early graft function were 98.5% and 89.8% versus 98.9% and 96.3% in the control group. Similar results were observed at 3 months posttransplant. Controlling for patient age, donor age, HLA-AB and -DR mismatches, cold ischemia time, acute rejection episodes, cyclosporine therapy, and waiting time for transplantation, we did not observe early graft function to be a risk factor for graft survival or patient survival. Glomerular filtration rate at 2, 5, and 6 years after kidney transplantation was significantly lower in the poor early graft function than in the control group.


CONCLUSIONS
This study suggested that the quality of early graft function had no significant effect on graft and patient survival rate, but did have a significant influence on long-term renal function.
Epidemiology Unit, Complexo Hospitalario Universitario A Coruña, A Coruña, Spain. salvador.pita.fernandez@sergas.es
S
S
Pita-Fernández
F
F
Valdés-Cañedo
T
T
Seoane-Pillado
D
D
Lorenzo-Aguiar
J
J
Oliver-Garcia
N
N
Blanco-Castro
R
R
Seijo-Bestilleiro
S
S
Pértega-Díaz
D005919:Glomerular Filtration Rate; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D016019:Survival Analysis