Alimi Rasoul, Hami Maryam, Afzalaghaee Monavar, Nazemian Fatemeh, Mahmoodi Mahmood, Yaseri Mehdi, Zeraati Hojjat
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Kidney Transplantation Complications Research Center, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Iran J Public Health. 2021 Oct;50(10):2076-2084. doi: 10.18502/ijph.v50i10.7508.
Graft and patient survival are of great importance after transplantation. This study aimed to determine the long-term survival rate of kidney transplantation and its effective factors among transplanted patients in Mashhad transplantation centers in northeastern Iran.
Overall, 618 kidney transplant recipients were examined in different transplantation centers during the years from 2000 to 2015 in a historical cohort study. The Kaplan-Meier method and the Log-rank test were used to calculate the survival rate of the kidney transplant, and to check the difference between survival curves respectively. Modeling of effective factors in survival rate was performed using Cox regression model.
Overall, 1, 3, 5, 7, 10, and 15-year survival rate of kidney transplantation were 99%, 98%, 97%, 93%, 88 and 70% respectively. The adjusted hazard ratio indicated that variables such as recipient age >40 yr [HR=0.22, 95% CI=(0.071,0.691)], serum creatinine after transplantation >1.6 Mg/dl [HR=3.03, 95% CI=(1.284,7.125)], history of hypertension [HR=6.70, 95% CI=(2.746,16.348)], and BMI [HR (normal weight versus underweight)=0.26, 95% CI=(0.088,0.761), HR (over weight versus underweight)=0.13,95% CI=(0.038,0.442)] were significant factors on kidney transplant survival rate.
The short-term transplant survival rate was good in transplant patients. What's more, through a consideration of variables such as age, creatinine serum after transplantation, history hypertension and body mass index, as well as proper planning to control their effect, it is possible to improve the long-term graft survival rate.
移植后的移植物和患者存活率至关重要。本研究旨在确定伊朗东北部马什哈德移植中心肾移植患者的长期存活率及其影响因素。
在一项历史性队列研究中，于2000年至2015年期间对不同移植中心的618名肾移植受者进行了检查。采用Kaplan-Meier法和对数秩检验分别计算肾移植的存活率并检验生存曲线之间的差异。使用Cox回归模型对存活率的影响因素进行建模。
总体而言，肾移植的1年、3年、5年、7年、10年和15年存活率分别为99%、98%、97%、93%、88%和70%。校正后的风险比表明，受者年龄>40岁[HR=0.22，95%CI=(0.071,0.691)]、移植后血清肌酐>1.6mg/dl[HR=3.03，95%CI=(1.284,7.125)]、高血压病史[HR=6.70，95%CI=(2.746,16.348)]以及体重指数[HR(正常体重与体重过轻)=0.26，95%CI=(0.088,0.761)，HR(超重与体重过轻)=0.13，95%CI=(0.038,0.442)]等变量是肾移植存活率的重要影响因素。
移植患者的短期移植存活率良好。此外，通过考虑年龄、移植后肌酐血清水平、高血压病史和体重指数等变量，并适当规划以控制其影响，有可能提高长期移植物存活率。
