Volume 33, Issue 4 (July 2022)
Studies in Medical Sciences 2022, 33(4): 244-255 |
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Mohammadrahii M, Abkhiz S, Fakour S, Farshid S. EVALUATION OF GRAFT SURVIVAL RATE FOLLOWING KIDNEY TRANSPLANTATION OF THE PATIENTS WITH AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DISEASE; A 19-YEAR FOLLOW-UP. Studies in Medical Sciences 2022; 33 (4) :244-255
URL: http://umj.umsu.ac.ir/article-1-5443-en.html
URL: http://umj.umsu.ac.ir/article-1-5443-en.html
Clinical Research Development Unit of Imam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran (Corresponding Author) , Farshid.s@umsu.ac.ir
Abstract: (1242 Views)
Background & Aims: Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease with a prevalence of 1 in 1000 people. The consequence of this disease is enlargement and deformity of the kidneys, which causes disruption of blood circulation and destruction of the parenchyma, and finally, impaired kidney function. Kidney failure is seen in 50% of the patients which makes the need of kidney transplantation in these patients. The aim of present study was to determine the graft survival rate in kidney transplantation of patients with autosomal dominant polycystic kidneys.
Materials & Methods: In this retrospective cohort study, 149 ADPKD patients who underwent kidney transplantation at Imam Khomeini Hospital in Urmia, Iran, between 1998 and 2016 were included in the study. Patients were evaluated for graft survival at intervals of one, six, twelve, twenty-four, thirty-six, forty-eight, and sixty months after transplantation and the causes of patient mortality and the risk factors of transplant rejection were investigated. Kaplan-Meier test was used to check graft survival and cox regression model was used to check rejection (hazard ratio) in the patients.
Results: Totally 149 patients (60.7% male and 38.3% female) with a mean age of 47.42 ±10.19 years were included. The rate of graft survival in men and women was respectively 98% and 97% in the first month, 90% and 97% in the sixth month, 87% and 93% in the twelfth month, 87% and 90% in the twenty-fourth month, 87% and 83% in the thirty-sixth month, 83% and 83% in the 48th month, and 78% and 80% in the 60th month. The mean overall graft survival was 52.96 months, 54.187 months in men, and 51.05 months in women, and this difference was significant (P=0.001). Also, evaluation of the risk of rejection (hazard ratio) showed that only the recipient's BMI had a significant relationship with the risk of transplant rejection. (OR=1.68, CI95% (1.34-4.22), P=0.001).
Conclusion: Based on the obtained results, it can be concluded that the 1-month, 6-month, 12-month, 24-month, 36-month, 48-month, and 60-month graft survival rate in ADPKD patients undergoing kidney transplantation in Hospital was appropriate, but it was a little low compared to the survival rate in previous years and most of the other centers. Although differences such as study design and environment are inevitable, but the results of this study can provide essential evidence for revising treatment strategies. Also, the recipient's body mass index has an effect on the probability of transplant rejection, and by considering this factor, it is possible to help increase the survival rate of kidney transplants in these patients.
Materials & Methods: In this retrospective cohort study, 149 ADPKD patients who underwent kidney transplantation at Imam Khomeini Hospital in Urmia, Iran, between 1998 and 2016 were included in the study. Patients were evaluated for graft survival at intervals of one, six, twelve, twenty-four, thirty-six, forty-eight, and sixty months after transplantation and the causes of patient mortality and the risk factors of transplant rejection were investigated. Kaplan-Meier test was used to check graft survival and cox regression model was used to check rejection (hazard ratio) in the patients.
Results: Totally 149 patients (60.7% male and 38.3% female) with a mean age of 47.42 ±10.19 years were included. The rate of graft survival in men and women was respectively 98% and 97% in the first month, 90% and 97% in the sixth month, 87% and 93% in the twelfth month, 87% and 90% in the twenty-fourth month, 87% and 83% in the thirty-sixth month, 83% and 83% in the 48th month, and 78% and 80% in the 60th month. The mean overall graft survival was 52.96 months, 54.187 months in men, and 51.05 months in women, and this difference was significant (P=0.001). Also, evaluation of the risk of rejection (hazard ratio) showed that only the recipient's BMI had a significant relationship with the risk of transplant rejection. (OR=1.68, CI95% (1.34-4.22), P=0.001).
Conclusion: Based on the obtained results, it can be concluded that the 1-month, 6-month, 12-month, 24-month, 36-month, 48-month, and 60-month graft survival rate in ADPKD patients undergoing kidney transplantation in Hospital was appropriate, but it was a little low compared to the survival rate in previous years and most of the other centers. Although differences such as study design and environment are inevitable, but the results of this study can provide essential evidence for revising treatment strategies. Also, the recipient's body mass index has an effect on the probability of transplant rejection, and by considering this factor, it is possible to help increase the survival rate of kidney transplants in these patients.
Keywords: Autosomal Dominant Polycystic Kidney Disease, Kidney Transplantation, Survival Rate, Transplant Rejection
References
1. Walker EYX, Marlais M. Should we screen for intracranial aneurysms in children with autosomal dominant polycystic kidney disease? Pediatr Nephrol 2022:1-9. [DOI:10.1007/s00467-022-05432-5] [PMID] [PMCID]
2. Chapman AB, Devuyst O, Eckardt K-U, Gansevoort RT, Harris T, Horie S, et al. Autosomal-dominant polycystic kidney disease (ADPKD): executive summary from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney Int 2015;88(1):17-27. [DOI:10.1038/ki.2015.59] [PMID] [PMCID]
3. Hateboer N, v Dijk MA, Bogdanova N, Coto E, Saggar-Malik AK, San Millan JL, et al. Comparison of phenotypes of polycystic kidney disease types 1 and 2. Lancet 1999;353(9147):103-7. [DOI:10.1016/S0140-6736(98)03495-3] [PMID]
4. Gimpel C, Bergmann C, Bockenhauer D, Breysem L, Cadnapaphornchai MA, Cetiner M, et al. International consensus statement on the diagnosis and management of autosomal dominant polycystic kidney disease in children and young people. Nat Rev Nephrol 2019;15(11):713-26. [DOI:10.1038/s41581-019-0155-2] [PMID] [PMCID]
5. Perrone RD, Malek AM, Watnick T. Vascular complications in autosomal dominant polycystic kidney disease. Nat Rev Nephrol 2015;11(10):589-98. [DOI:10.1038/nrneph.2015.128] [PMID] [PMCID]
6. Silverio A, Prota C, Di Maio M, Polito MV, Cogliani FM, Citro R, et al. Aortic dissection in patients with autosomal dominant polycystic kidney disease: a series of two cases and a review of the literature. Nephrol 2015;20(4):229-35. [DOI:10.1111/nep.12373] [PMID]
7. Abdullahi M, Ismail A, Ahmad A. Renal cell carcinoma arising within autosomal dominant polycystic kidney disease. Ann Trop Pathol 2021;12(1):32. [Google Scholar]
8. Perumareddi P, Trelka DP. Autosomal dominant polycystic kidney disease. Prim Care - Clin Off Pract 2020;47(4):673-89. [DOI:10.1016/j.pop.2020.08.010] [PMID]
9. Al-Khader AA. Hypertension in autosomal dominant polycystic kidney disease. Saudi J Kidney Dis Transplan 1999;10(3):349. [PMID]
10. Bajwa ZH, Gupta S, Warfield CA, Steinman TI. Pain management in polycystic kidney disease. Kidney Int 2001;60(5):1631-44. [DOI:10.1046/j.1523-1755.2001.00985.x] [PMID]
11. Cornec-Le Gall E, Alam A, Perrone RD. Autosomal dominant polycystic kidney disease. Lancet 2019;393(10174):919-35. [DOI:10.1016/S0140-6736(18)32782-X] [PMID]
12. Sulikowski T, Tejchman K, Ziętek Z, Różański J, Domański L, Kamiński M, et al. Experience with autosomal dominant polycystic kidney disease in patients before and after renal transplantation: a 7-year observation. Transplant proceed; (41(1):177-80. [DOI:10.1016/j.transproceed.2008.10.034] [PMID]
13. Xu D, Ma Y, Gu X, Bian R, Lu Y, Xing X, et al. Novel mutations in the PKD1 and PKD2 genes of Chinese patients with autosomal dominant polycystic kidney disease. Kidney Blood Press Res 2018;43(2):297-309. [DOI:10.1159/000487899] [PMID]
14. Audrézet M-P, Corbiere C, Lebbah S, Morinière V, Broux F, Louillet F, et al. Comprehensive PKD1 and PKD2 mutation analysis in prenatal autosomal dominant polycystic kidney disease. J Am Soc Nephrol 2016;27(3):722-9. [DOI:10.1681/ASN.2014101051] [PMID] [PMCID]
15. Rozanski J, Kozlowska I, Myslak M, Domanski L, Sienko J, Ciechanowski K, Ostrowski M. Pretransplant nephrectomy in patients with autosomal dominant polycystic kidney disease. InTransplantation proceedings 2005;32(2):666-8. [DOI:10.1016/j.transproceed.2004.12.115] [PMID]
16. Mei C-L, Xue C, Yu S-Q, Dai B, Chen J-H, Li Y, et al. Executive summary: clinical practice guideline for autosomal dominant polycystic kidney disease in China. Kidney Dis 2020;6(3):144-9. [DOI:10.1159/000506288] [PMID] [PMCID]
17. Illesy L, Kovacs DA, Szabo RP, Asztalos ABL, Nemes B. Autosomal dominant polycystic kidney disease transplant recipients after kidney transplantation: a single-center experience. Transplant Proceed 49(7):1522-5. [DOI:10.1016/j.transproceed.2017.06.014] [PMID]
18. Alzoubi B, Kharel A, Osman F, Aziz F, Garg N, Mohamed M, et al. Incidence, risk factors, and outcomes of post‐transplant erythrocytosis after kidney transplantation. Clin Transplant 2021;35(2):e14166. [DOI:10.1111/ctr.14166]
19. Perico N, Cortinovis M, Remuzzi G. Renal transplantation in Autosomal Dominant Polycystic Kidney Disease (ADPKD). G Ital Nefrol 2016;33(5). [PMID]
20. Cheungpasitporn W, Thongprayoon C, Vijayvargiya P, Anthanont P, Erickson SB. The risk for new-onset diabetes mellitus after kidney transplantation in patients with autosomal dominant polycystic kidney disease: a systematic review and meta-analysis. Can J Diabet 2016;40(6):521-8. [DOI:10.1016/j.jcjd.2016.03.001] [PMID]
21. Tsai TY, Chen CH, Wu MJ, Tsai SF. Outcomes of Kidney Transplantation in Patients with Autosomal Dominant Polycystic Kidney Disease: Our Experience Based on 35-Years Follow-Up. Diagnostics 2022;12(5):1174. [DOI:10.3390/diagnostics12051174] [PMID] [PMCID]
22. Gonçalves S, Guerra J, Santana A, Abreu F, Mil-Homens C, da Costa AG, editors. Autosomal-dominant polycystic kidney disease and kidney transplantation: experience of a single center. Transplantation proceedings; 2009: Elsevier. [DOI:10.1016/j.transproceed.2009.01.069] [PMID]
23. Roozbeh J, Razmkon AR, Jalaeian H, Raiss-Jalali GA, Behzadi S, Sagheb MM, et al. Outcome of kidney transplantation in patients with polycystic kidney disease: A single center study. Saudi J Kidney Dis Transplant 2008;19(1):72. [Google Scholar]
24. Hassanzadeh J, Hashiani AA, Rajaeefard A, Salahi H, Khedmati E, Kakaei F, et al. Long-term survival of living donor renal transplants: A single center study. Indian J Nephrol 2010;20(4):179-84. [DOI:10.4103/0971-4065.73439] [PMID] [PMCID]
25. Hart A, Smith JM, Skeans MA, Gustafson SK, Stewart DE, Cherikh WS, et al. Kidney. Am J Transplant 2016;16 Suppl 2(Suppl 2):11-46. [DOI:10.1111/ajt.13666] [PMID] [PMCID]
26. Kramer A, Boenink R, Noordzij M, Bosdriesz JR, Stel VS, Beltrán P, Ruiz JC, Seyahi N, Comas Farnés J, Stendahl M, Garneata L. The ERA-EDTA registry annual report 2017: a summary. Clin Kidney J 2020;13(4):693-709. [DOI:10.1093/ckj/sfaa048] [PMID] [PMCID]
27. Register CO. and Canadian Institute for Health Information. 2015 CORR annual report: treatment of end-stage organ failure in Canada. 2004;2013. [Available from: https://www.cihi.ca/en/types-of-care/specialized-services/organ-replacements. [URL]
28. Anzdata Registry. 38th Report, Chapter 8: transplantation: Australia and New Zealand Dialysis and Transplant Registry, Adelaide, Australia; 2016 [Available from: http://www.anzdata.org.au. [URL]
29. Behbehani P, Beladi Mousavi S, Shayanpour S, Hayati F, Shahbazian H. Patient and Graft Survival Rates in 1, 5 and 10 Years after Kidney Transplantation in Khouzestan between 2008-2018. Jundishapur Sci Med J 2019;18(5):533-46. [URL]
30. Shahbazi F, Ranjbaran M, Karami-Far S, Soori H, Manesh HJ. Graft survival rate of renal transplantation during a period of 10 years in Iran. J Res Med Sci 2015;20(11):1046-52. [DOI:10.4103/1735-1995.172814] [PMID] [PMCID]
31. Chen PD, Tsai MK, Lee CY, Yang CY, Hu RH, Lee PH, et al. Gender differences in renal transplant graft survival. J Formos Med Assoc 2013;112(12):783-8. [DOI:10.1016/j.jfma.2013.10.011] [PMID]
32. Bozkurt B, Kumru A, Dumlu EG, Tokaç M, Koçak H, Süleymanlar G, et al. Patient and graft survival after pre-emptive versus non-pre-emptive kidney transplantation: a single-center experience from Turkey. Transplant Proc 2013;45(3):932-4. [DOI:10.1016/j.transproceed.2013.02.064] [PMID]
33. Ghelichi Ghojogh M, Taghizadeh Afshari A, Khalkhali HR, Moahammad Reza M-F, Makhdoomi K, Salarilak S. comparing graft survival and patient survival rate of renal transplantation in diabeticpatients,in the imam khomeini hospital transplantation center, urmia,iran (2001-2011). Stud Med Sci 2015;26(1):47-55. [Google Scholar]
34. Javanrouh Givi N, Alimi R, Esmaily H, Shakeri MT, Shamsa A. Assessment of effective factors on renal transplantation survival and estimation of rejection hazard for transplanted in Mashhad Qaem hospital. J N Khorasan Univ Med Sci 2013;5(2):315-21. [DOI:10.29252/jnkums.5.2.315]
35. Hashiani AA, Rajaeefard A, Hasanzadeh J, Kakaei F, Behbahan AG, Nikeghbalian S, et al. Ten-year graft survival of deceased-donor kidney transplantation: a single-center experience. Ren Fail 2010;32(4):440-7. [DOI:10.3109/08860221003650347] [PMID]
36. Ghanei E, Nasrolahi A, Razaghi M. Evaluation Short and Long term graft and survival rates in kidney transplanted patients between 1995-2011. Ann Mil Health Sci Res 2012;9(4):251-5.
37. Einollahi B, Pourfarziani V, Ahmadzad-Asl M, Davoudi F, Lessan-Pezeshki M, Davoudi A, et al. Iranian model of renal allograft transplantation in 3028 recipients: survival and risk factors. Transplant Proc 2007;39(4):907-10. [DOI:10.1016/j.transproceed.2007.03.033] [PMID]
38. Ghelichi-Ghojogh M, Ghaem H, Mohammadizadeh F, Vali M, Ahmed F, Hassanipour S, et al. Graft and Patient Survival Rates in Kidney Transplantation, and Their Associated Factors: A Systematic Review and Meta-Analysis. Iran J Public Health 2021;50(8):1555-63. [DOI:10.18502/ijph.v50i8.6801] [PMID] [PMCID]
39. Saatchi M, Poorolajal J, Amirzargar MA, Mahjub H, Esmailnasab N. Long-term survival rate of kidney graft and associated prognostic factors: a retrospective cohort study, 1994-2011. Ann Transplant 2013;18:153-60. [DOI:10.12659/AOT.883873] [PMID]
40. Tang H, Chelamcharla M, Baird BC, Shihab FS, Koford JK, Goldfarb-Rumyantzev AS. Factors affecting kidney-transplant outcome in recipients with lupus nephritis. Clin Transplant 2008;22(3):263-72. [DOI:10.1111/j.1399-0012.2007.00781.x] [PMID]
41. Kaur K, Jun D, Grodstein E, Singer P, Castellanos L, Teperman L, et al. Outcomes of underweight, overweight, and obese pediatric kidney transplant recipients. Pediatr Nephrol 2018;33(12):2353-62. [DOI:10.1007/s00467-018-4038-8] [PMID]
42. Winnicki E, Dharmar M, Tancredi DJ, Nguyen S, Butani L. Effect of BMI on allograft function and survival in pediatric renal transplant recipients. Pediatr Nephrol 2018;33(8):1429-35. [DOI:10.1007/s00467-018-3942-2] [PMID]
43. Naik AS, Sakhuja A, Cibrik DM, Ojo AO, Samaniego-Picota MD, Lentine KL. The Impact of Obesity on Allograft Failure After Kidney Transplantation: A Competing Risks Analysis. Transplantation 2016;100(9):1963-9. [DOI:10.1097/TP.0000000000000983] [PMID]
44. Kwan JM, Hajjiri Z, Metwally A, Finn PW, Perkins DL. Effect of the Obesity Epidemic on Kidney Transplantation: Obesity Is Independent of Diabetes as a Risk Factor for Adverse Renal Transplant Outcomes. PLoS One 2016;11(11):e0165712. [DOI:10.1371/journal.pone.0165712] [PMID] [PMCID]
45. Hill CJ, Courtney AE, Cardwell CR, Maxwell AP, Lucarelli G, Veroux M, et al. Recipient obesity and outcomes after kidney transplantation: a systematic review and meta-analysis. Nephrol Dial Transplant 2015;30(8):1403-11. [DOI:10.1093/ndt/gfv214] [PMID]
46. Ladhani M, Lade S, Alexander SI, Baur LA, Clayton PA, McDonald S, et al. Obesity in pediatric kidney transplant recipients and the risks of acute rejection, graft loss and death. Pediatr Nephrol 2017;32(8):1443-50. [DOI:10.1007/s00467-017-3636-1] [PMID]
47. Hadimeri H, Norden G, Friman S, Nyberg G. Autosomal dominant polycystic kidney disease in a kidney transplant population. Nephrol Dial Transplant 1997;12(7):1431-6. [DOI:10.1093/ndt/12.7.1431] [PMID]
48. Jacquet A, Pallet N, Kessler M, Hourmant M, Garrigue V, Rostaing L, et al. Outcomes of renal transplantation in patients with autosomal dominant polycystic kidney disease: a nationwide longitudinal study. Transpl Int 2011;24(6):582-7. [DOI:10.1111/j.1432-2277.2011.01237.x] [PMID]
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