Over 5 Years of Excellent Graft Kidney Function Determinants: Baskent University Experience

Abstract

Objectives: Kidney graft survival may be evaluated according to the duration of time with a functioning graft. Survival alone may not satisfy expectations of a successful kidney transplant if the graft kidney does not show excellent function. In our study, we analyzed the characteristics of kidney transplant recipients who showed excellent graft function after 5 to 10 years of follow-up in an aim to improve graft survival and to ensure the best kidney function in the long term.

Materials and Methods: We retrospectively evaluated graft function and demographic characteristics of 288 patients who underwent kidney transplant between January 2008 and December 2012.

Results: We found that 149 patients (51.7%) had excellent graft function, 88 patients (30.5%) had a functioning graft with a glomerular filtration rate lower than 60 mL/min and/or had signs of graft kidney dysfunction, and 45 patients (15.6%) experienced graft loss. Of 288 kidney transplant recipients enrolled in the study, most were male (56%), and mean age was 30.47 +/- 14.36 years at time of transplant. Median time on dialysis was 39.09 +/- 59.30 months. The overall graft survival rate in the patient group was 82.2% after 5 to 10 years of follow-up. Multivariate analysis showed that excellent graft survival predictors beyond 5 years were negative panel reactive antibody levels, lower donor age, shorter duration on dialysis, absence of acute rejection episodes, 3 or less HLA mismatches, lower immunosuppressive levels, and lower recipient age at transplant.

Conclusions: Lower panel reactive antibody levels, lower donor age, shorter duration on dialysis, absence of acute rejection episodes, 3 or less HLA mismatches, and lower recipient age at transplant are major determinants of excellent graft survival in our kidney transplant recipients.