title: Over ten-year kidney graft survival determinants.
abstract: Kidney graft survival has been mainly evaluated using an up to 10-year threshold. Instead, in this study our aim was to evaluate predictive variables that impact long-term kidney graft survival (≥10 years). We enrolled 892 patients in our analysis: 638 patients with functioning graft at 10 years PT and 254 patients with graft failure at 10 years PT (considering patient death with a functioning graft <10 years PT as graft failure). Between groups comparisons were done using Mann-Whitney and chi-square test. To determine independent predictive variables for long-term graft survival a multivariate-adjusted logistic regression was performed. Significant predictors of long term graft survival were lower 12-month PT creatinine (OR = 0.26, P < 0.001), lower donor age (OR = 0.98, P = 0.004), shorter time on dialysis (OR = 0.93, P = 0.044), recipient positive CMV IgG (OR = 1.59, P = 0.040), absence of AR episodes (OR = 1.57, P = 0.047), 0 to 1 (versus 2) HLA-B mismatch (OR = 1.80, P = 0.004), and recipients male gender (OR = 1.84, P = 0.005). Our results show that an early KT, younger donor age, and an optimal first year graft function are of paramount importance for long-term graft survival. Measures that address these issues (careful donor selection, preemptive KT, and effective immunosuppressive protocols) are still warranted.
authors.affiliation: Serviço de Nefrologia, Hospital de Santo António, 4099-001 Porto, Portugal ; Serviço de Nefrologia, Hospital de Faro, Rua Leão Penedo, 8000 Faro, Portugal.
authors.forename: Anabela Malho
authors.initials: AM
authors.lastname: Guedes
authors.forename: Jorge
authors.initials: J
authors.lastname: Malheiro
authors.forename: Isabel
authors.initials: I
authors.lastname: Fonseca
authors.forename: La Salete
authors.initials: LS
authors.lastname: Martins
authors.forename: Sofia
authors.initials: S
authors.lastname: Pedroso
authors.forename: Manuela
authors.initials: M
authors.lastname: Almeida
authors.forename: Leonídio
authors.initials: L
authors.lastname: Dias
authors.forename: António
authors.initials: A
authors.lastname: Castro Henriques
authors.forename: António
authors.initials: A
authors.lastname: Cabrita