title: Recipient Criteria Predictive of Graft Failure in Kidney Transplantation.
abstract: Several classifications systems have been developed to predict outcomes of kidney transplantation based on donor variables. This study aims to identify kidney transplant recipient variables that would predict graft outcome irrespective of donor characteristics. All U.S. kidney transplant recipients between October 25,1999 and January 1, 2007 were reviewed. Cox proportional hazards regression was used to model time until graft failure. Death-censored and nondeath-censored graft survival models were generated for recipients of live and deceased donor organs. Recipient age, gender, body mass index (BMI), presence of cardiac risk factors, peripheral vascular disease, pulmonary disease, diabetes, cerebrovascular disease, history of malignancy, hepatitis B core antibody, hepatitis C infection, dialysis status, panel-reactive antibodies (PRA), geographic region, educational level, and prior kidney transplant were evaluated in all kidney transplant recipients. Among the 88,284 adult transplant recipients the following groups had increased risk of graft failure: younger and older recipients, increasing PRA (hazard ratio [HR],1.03-1.06], increasing BMI (HR, 1.04-1.62), previous kidney transplant (HR, 1.17-1.26), dialysis at the time of transplantation (HR, 1.39-1.51), hepatitis C infection (HR, 1.41-1.63), and educational level (HR, 1.05-1.42). Predictive criteria based on recipient characteristics could guide organ allocation, risk stratification, and patient expectations in planning kidney transplantation.
authors.affiliation: Department of Surgery, Hofstra North Shore-LIJ School of Medicine, New York; Department of Medicine, Hofstra North Shore-LIJ School of Medicine, New York.
authors.forename: Ernesto P
authors.initials: EP
authors.lastname: Molmenti
authors.affiliation: Department of Surgery, Hofstra North Shore-LIJ School of Medicine, New York.
authors.forename: Asha
authors.initials: A
authors.lastname: Alex
authors.affiliation: The Feinstein Institute for Medical Research, Hofstra North Shore-LIJ School of Medicine, New York.
authors.forename: Lisa
authors.initials: L
authors.lastname: Rosen
authors.affiliation: Department of Medicine, Hofstra North Shore-LIJ School of Medicine, New York.
authors.forename: Mohini
authors.initials: M
authors.lastname: Alexander
authors.affiliation: Department of Surgery, Hofstra North Shore-LIJ School of Medicine, New York.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Nicastro
authors.affiliation: Mailman School of Public Health, Columbia University, New York.
authors.forename: Jingyan
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Surgery, Hofstra North Shore-LIJ School of Medicine, New York.
authors.forename: Eric
authors.initials: E
authors.lastname: Siskind
authors.affiliation: Department of Surgery, Hofstra North Shore-LIJ School of Medicine, New York.
authors.forename: Leesha
authors.initials: L
authors.lastname: Alex
authors.affiliation: The Feinstein Institute for Medical Research, Hofstra North Shore-LIJ School of Medicine, New York.
authors.forename: Emil
authors.initials: E
authors.lastname: Sameyah
authors.affiliation: Department of Medicine, Hofstra North Shore-LIJ School of Medicine, New York.
authors.forename: Madhu
authors.initials: M
authors.lastname: Bhaskaran
authors.affiliation: Department of Medicine, Hofstra North Shore-LIJ School of Medicine, New York.
authors.forename: Nicole
authors.initials: N
authors.lastname: Ali
authors.affiliation: Department of Surgery, Hofstra North Shore-LIJ School of Medicine, New York.
authors.forename: Amit
authors.initials: A
authors.lastname: Basu
authors.affiliation: Department of Medicine, Hofstra North Shore-LIJ School of Medicine, New York.
authors.forename: Mala
authors.initials: M
authors.lastname: Sachdeva
authors.affiliation: Department of Surgery, Hofstra North Shore-LIJ School of Medicine, New York.
authors.forename: Stergiani
authors.initials: S
authors.lastname: Agorastos
authors.affiliation: Department of Surgery, Hofstra North Shore-LIJ School of Medicine, New York.
authors.forename: Prejith
authors.initials: P
authors.lastname: Rajendran
authors.affiliation: Department of Surgery, Hofstra North Shore-LIJ School of Medicine, New York.
authors.forename: Prathik
authors.initials: P
authors.lastname: Krishnan
authors.affiliation: Department of Surgery, Hofstra North Shore-LIJ School of Medicine, New York.
authors.forename: Poornima
authors.initials: P
authors.lastname: Ramadas
authors.affiliation: Department of Surgery, Hofstra North Shore-LIJ School of Medicine, New York.
authors.forename: Leo
authors.initials: L
authors.lastname: Amodu
authors.affiliation: Department of Surgery, Hofstra North Shore-LIJ School of Medicine, New York.
authors.forename: Joaquin
authors.initials: J
authors.lastname: Cagliani
authors.affiliation: Department of Surgery, Hofstra North Shore-LIJ School of Medicine, New York.
authors.forename: Sameer
authors.initials: S
authors.lastname: Rehman
authors.affiliation: Department of Surgery, Hofstra North Shore-LIJ School of Medicine, New York.
authors.forename: Adam
authors.initials: A
authors.lastname: Kressel
authors.affiliation: Department of Pediatrics, Hofstra North Shore-LIJ School of Medicine, New York.
authors.forename: Christine B
authors.initials: CB
authors.lastname: Sethna
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany.
authors.forename: Georgios C
authors.initials: GC
authors.lastname: Sotiropoulos
authors.affiliation: Department of General and Visceral Surgery, University Hospital Muenster, Albert-Schweitzer-Campus, Muenster, Germany.
authors.forename: Arnold
authors.initials: A
authors.lastname: Radtke
authors.affiliation: Department of General Surgery, Red Cross Hospital, Athens, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Sgourakis
authors.affiliation: Department of Medicine, Hofstra North Shore-LIJ School of Medicine, New York.
authors.forename: Richard
authors.initials: R
authors.lastname: Schwarz
authors.affiliation: Department of Medicine, Hofstra North Shore-LIJ School of Medicine, New York.
authors.forename: Steven
authors.initials: S
authors.lastname: Fishbane
authors.affiliation: Department of Medicine, Hofstra North Shore-LIJ School of Medicine, New York.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Bellucci
authors.affiliation: Department of Surgery, Hofstra North Shore-LIJ School of Medicine, New York.
authors.forename: Gene
authors.initials: G
authors.lastname: Coppa
authors.affiliation: Department of Surgery, Hofstra North Shore-LIJ School of Medicine, New York.
authors.forename: Horacio
authors.initials: H
authors.lastname: Rilo
authors.affiliation: Mailman School of Public Health, Columbia University, New York.
authors.forename: Christine L
authors.initials: CL
authors.lastname: Molmenti
keywords: comorbidities; geographic disparities; graft failure; kidney transplant recipients; outcomes predictors; patient education