title: Return to work after renal transplantation: a study of the Brazilian Public Social Security System.
abstract: BACKGROUND
  Return to work is an objective parameter used worldwide to evaluate the success of organ transplantation and is especially feasible after renal transplantation. This study sought to describe the frequency of return to work after renal transplantation and related characteristics.
  
  
  METHODS
  Retrospective cohort of 511 isolated kidney transplant recipients was recruited from a Brazilian referral center from January 2005 to December 2009; all were matched to the public social security database to determine inclusion and benefit awards, as well as the rate of resumption of contributions to the public social security system, a surrogate marker of work rehabilitation. Characteristics associated with work return were analyzed.
  
  
  RESULTS
  No social security records were found for 28 subjects. The remaining 483 subjects had a mean age of 45±13 years; 62% were male; 401 (83%) received some public social security benefit; 298 were paying dues and could, therefore, receive temporary or permanent disability benefits. Of these, 78 subjects made social security payments after transplantation, resulting in a work return rate of 26% (95% confidence interval, 21-32). Younger age, living donor graft, and chronic glomerulonephritis were significantly associated with return to work.
  
  
  CONCLUSIONS
  In Brazil, most renal transplant recipients are on social security benefits, but only a small proportion return to work after surgery. Clinical characteristics may help define work resumption trends.
authors.affiliation: 1 Kidney and Pancreas Transplant Unit (Hospital Dom Vicente Scherer), Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil. 2 Agência de Benefícios por Incapacidade-Partenon II, Instituto Nacional do Seguro Social (INSS) (Porto Alegre Disability Benefits Branch of the Brazilian National Institute of Social Security), Porto Alegre, Rio Grande do Sul, Brazil. 3 Biostatistics Unit, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil. 4 Address correspondence to: Alexandre Augusto Messias, M.D., Rua Tremembé, 80, casa 9, Vila Jardim CEP 91330-650, Porto Alegre, Rio Grande do Sul, Brazil.
authors.forename: Alexandre Augusto
authors.initials: AA
authors.lastname: Messias
authors.forename: Angela J
authors.initials: AJ
authors.lastname: Reichelt
authors.forename: Edson F
authors.initials: EF
authors.lastname: Dos Santos
authors.forename: Galton C
authors.initials: GC
authors.lastname: Albuquerque
authors.forename: José S P
authors.initials: JS
authors.lastname: Kramer
authors.forename: Vania N
authors.initials: VN
authors.lastname: Hirakata
authors.forename: Valter D
authors.initials: VD
authors.lastname: Garcia
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001938:Brazil; D004651:Employment; D005260:Female; D005921:Glomerulonephritis / Q000150:complications; D006801:Humans; D016030:Kidney Transplantation / Q000191:economics / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D051437:Renal Insufficiency / Q000191:economics / Q000601:surgery*; D012189:Retrospective Studies; D062707:Return to Work; D012943:Social Security; D055815:Young Adult