Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Feb 11;19(4):2010.
doi: 10.3390/ijerph19042010.

Organization of Post-Transplant Care and the 5-Year Outcomes of Kidney Transplantation

Agnieszka Szymańska  1 , Krzysztof Mucha  1   2 , Maciej Kosieradzki  3 , Sławomir Nazarewski  4 , Leszek Pączek  1   2 , Bartosz Foroncewicz  1
Affiliations

Organization of Post-Transplant Care and the 5-Year Outcomes of Kidney Transplantation

Agnieszka Szymańska et al. Int J Environ Res Public Health. .

Abstract

The outcomes of kidney transplantation depend on numerous factors and vary between transplant centers. The aim of this study is to assess the relationship between selected organizational factors, comorbidities, and patient and graft survival. This is a retrospective analysis of 438 renal transplant recipients (RTR) followed for 5 years. Patient and graft survival were evaluated in relation to hospitalization length, distance from the patient's residence to the transplant center, the frequency of outpatient transplant visits, and the number and type of comorbidities. Five-year patient and graft survival rates were 93% and 90%, respectively. We found significant associations of patient survival with the prevalence of pre-transplant diabetes, cardiovascular diseases, malignancies, the number of comorbidities, and the first post-transplant hospitalization length. The incidence of infections, cardiovascular diseases, and transplanted kidney diseases was 60%, 40%, and 33%, respectively. As many as 41% of RTR had unknown etiology of primary kidney disease. In conclusion, the organization of post-transplant care needs to be adapted to the multi-morbidity of contemporary RTR and include multi-specialist care, especially in the context of current problems related to the COVID-19pandemic. The high proportion of patients with undetermined etiology of their primary renal disease carry the risk for additional complications during their long-term follow-up.

Keywords: comorbidities; follow-up; kidney transplantation; organization; outcome.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest related to this manuscript.

Figures

Figure 1
Figure 1
Kaplan–Meier estimates of the 5-year patient and graft survival in the entire studied transplant population.
Figure 2
Figure 2
The Kaplan–Meier estimates of the 5-year patient (a) and graft (b) survival in RTR transplanted in two surgical centers (SC1 and SC2).
Figure 3
Figure 3
The association of patient survival with the length of the first hospitalization (Mann-Whitney test).
Figure 4
Figure 4
The association of graft survival with the first hospitalization length (a) and with the number of outpatient visits (b) (Mann–Whitney test).
Figure 5
Figure 5
The Kaplan–Meier estimates of the 5-year patient (a) and graft (b) survival in two transplantation periods: 2005–2008 and 2009–2012.
Figure 6
Figure 6
The association between the number of comorbidities and patient survival (Mann–Whitney test).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Wang J.H., Skeans M.A., Israni A.K. Current Status of Kidney Transplant Outcomes: Dying to Survive. Adv. Chronic Kidney Dis. 2016;23:281–286. doi: 10.1053/j.ackd.2016.07.001. - DOI - PubMed
    1. Ojo A.O., Morales J.M., González-Molina M., Steffick D.E., Luan F.L., Merion R.M., Ojo T., Moreso F., Arias M., Campistol J.M., et al. Comparison of the long-term outcomes of kidney transplantation: USA versus Spain. Nephrol. Dial. Transplant. 2013;28:213–220. doi: 10.1093/ndt/gfs287. - DOI - PMC - PubMed
    1. Gondos A., Dohler B., Brenner H., Opelz G. Kidney graft survival in Europe and the United States: Strikingly different long-term outcomes. Transplantation. 2013;95:267–274. doi: 10.1097/TP.0b013e3182708ea8. - DOI - PubMed
    1. Lim M.A., Kohli J., Bloom R.D. Immunosuppression for kidney transplantation: Where are we now and where are we going? Transplant. Rev. 2017;31:10–17. doi: 10.1016/j.trre.2016.10.006. - DOI - PubMed
    1. Ciszek M., Mucha K., Foroncewicz B., Żochowska D., Kosieradzki M., Grochowiecki T., Durlik M., Górski A., Pączek L. Immune biomarkers and long-term graft survival: A prospective follow-up of 457 kidney transplant recipients. Pol. Arch. Int. Med. 2017;127:178–183. - PubMed