Outcome of Kidney Transplant Recipients with Graft Failure

Author(s): Ali AlShaqaq, Maher AlDemerdash, Meteb M AlBugami, Baher Elgadaa, Najib Musaied, Ibtihal Shaikh, Alwaiah AlRamdhan, Abdulnaser AlAbadi, Khaled Hamawi, Fahad E AlOtaibe, Khalid Bel’eed Akkari.

Background: Kidney transplantation is the optimal choice for patients with end stage renal disease. However, most kidney grafts will fail at some point during the lifetime of the recipient. This study presents outcome data in patients with failed kidney graft.

Methods: Data from 1309 kidney transplant recipients were reviewed. Multivariable cox regression analysis was used to study the predictors of graft and patient outcomes.

Results: We identified 85 kidney transplant recipients with graft failure and matched them to 170 patients with functioning graft. Mean age of the participants was 44.9 (±15.7) years. Chronic rejection was the most common cause of graft failure (31.7%). Fifty-five patients (64.7%) return to dialysis after graft failure, 13 patients (15.3%) underwent repeat transplantation, and 17 patients (20%) died. A multivariable cox regression analysis showed that increased age was associated with worse patient survival. Graft loss was associated with the diagnosis of diabetes mellitus and hypertension.

Conclusion: Patients with kidney graft failure experience significant morbidity and mortality. Strategies to optimize outcomes of such patients are needed with a focus on maximizing opportunities for re-listing and repeat transplantation.