A Retrospective Case-Control Study Exploring Risk Factors for Loss of Kidney Transplant Function or Death Among Indigenous Transplant Recipients

N. Khanal, P. Lawton, A. Cass, S. McDonald

Research output: Contribution to journalMeeting AbstractResearch

Abstract

Introduction: Rates of graft failure and death related to infection are substantially higher among Indigenous transplant recipients. We explored detailed risk‐factors for graft and patient survival, beyond information available from the ANZDATA Registry.

Methods: Case‐control study was conducted among indigenous transplant recipients in SA and NT 2005‐2015. Cases were those who received a kidney transplant and sustained graft loss (patient death or graft failure) within 5 years. Controls were matched (1:1) on time from transplantation and age. Medical records of participants were reviewed. Information was collected on hospital admissions and infections for 2 years pre and post kidney transplant.

Results: Of the 82 participants who met the inclusion criteria, 16 patients sustained graft loss in 2 years since transplant, and a further 7 patients within 5. 20 patients without graft loss were selected as controls. 60% participants were from NT and 40% from SA. There were 3.5 median pre‐transplant admissions per control (inter‐quartile range (IQR) 1.5, 8) and 3 (2, 6) admissions per case and 5.5 median post‐transplant admissions per control (IQR 4, 9) and 7 (2, 15) per case. Infection related admissions accounted for 83 (19.3%) admission episodes pre‐transplant and 176 (29.3%) post‐transplant. CMV PCR was positive in 11(55%) of cases and controls. BK viraemia was detected in 5 (25%) controls and 7 (30%) cases. Odds ratio (OR) for graft loss and infection related admissions were similar in cases and controls in pre‐transplant period [OR 1.0, 95% confidence interval (CI) 0.1‐7.1]and in post‐transplant period 0.7 (95% CI 0.1‐4.0).

Conclusion: This study highlights the high frequency of infection related admissions before and after transplantation. To date, these are not associated with graft and patient outcome.
Original languageEnglish
Pages (from-to)26-26
Number of pages1
JournalNephrology
Volume23
Issue numberS3
Early online date30 Aug 2018
DOIs
Publication statusPublished - Sep 2018

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Case-Control Studies
Transplants
Kidney
Infection
Transplantation
Odds Ratio
Transplant Recipients
Confidence Intervals
Viremia
Graft Survival
Cross Infection
Medical Records
Registries
Polymerase Chain Reaction

Cite this

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title = "A Retrospective Case-Control Study Exploring Risk Factors for Loss of Kidney Transplant Function or Death Among Indigenous Transplant Recipients",
abstract = "Introduction: Rates of graft failure and death related to infection are substantially higher among Indigenous transplant recipients. We explored detailed risk‐factors for graft and patient survival, beyond information available from the ANZDATA Registry.Methods: Case‐control study was conducted among indigenous transplant recipients in SA and NT 2005‐2015. Cases were those who received a kidney transplant and sustained graft loss (patient death or graft failure) within 5 years. Controls were matched (1:1) on time from transplantation and age. Medical records of participants were reviewed. Information was collected on hospital admissions and infections for 2 years pre and post kidney transplant.Results: Of the 82 participants who met the inclusion criteria, 16 patients sustained graft loss in 2 years since transplant, and a further 7 patients within 5. 20 patients without graft loss were selected as controls. 60{\%} participants were from NT and 40{\%} from SA. There were 3.5 median pre‐transplant admissions per control (inter‐quartile range (IQR) 1.5, 8) and 3 (2, 6) admissions per case and 5.5 median post‐transplant admissions per control (IQR 4, 9) and 7 (2, 15) per case. Infection related admissions accounted for 83 (19.3{\%}) admission episodes pre‐transplant and 176 (29.3{\%}) post‐transplant. CMV PCR was positive in 11(55{\%}) of cases and controls. BK viraemia was detected in 5 (25{\%}) controls and 7 (30{\%}) cases. Odds ratio (OR) for graft loss and infection related admissions were similar in cases and controls in pre‐transplant period [OR 1.0, 95{\%} confidence interval (CI) 0.1‐7.1]and in post‐transplant period 0.7 (95{\%} CI 0.1‐4.0).Conclusion: This study highlights the high frequency of infection related admissions before and after transplantation. To date, these are not associated with graft and patient outcome.",
keywords = "Urology & Nephrology",
author = "N. Khanal and P. Lawton and A. Cass and S. McDonald",
year = "2018",
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doi = "10.1111/nep.13441",
language = "English",
volume = "23",
pages = "26--26",
journal = "Nephrology",
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A Retrospective Case-Control Study Exploring Risk Factors for Loss of Kidney Transplant Function or Death Among Indigenous Transplant Recipients. / Khanal, N.; Lawton, P.; Cass, A.; McDonald, S.

In: Nephrology, Vol. 23, No. S3, 09.2018, p. 26-26.

Research output: Contribution to journalMeeting AbstractResearch

TY - JOUR

T1 - A Retrospective Case-Control Study Exploring Risk Factors for Loss of Kidney Transplant Function or Death Among Indigenous Transplant Recipients

AU - Khanal, N.

AU - Lawton, P.

AU - Cass, A.

AU - McDonald, S.

PY - 2018/9

Y1 - 2018/9

N2 - Introduction: Rates of graft failure and death related to infection are substantially higher among Indigenous transplant recipients. We explored detailed risk‐factors for graft and patient survival, beyond information available from the ANZDATA Registry.Methods: Case‐control study was conducted among indigenous transplant recipients in SA and NT 2005‐2015. Cases were those who received a kidney transplant and sustained graft loss (patient death or graft failure) within 5 years. Controls were matched (1:1) on time from transplantation and age. Medical records of participants were reviewed. Information was collected on hospital admissions and infections for 2 years pre and post kidney transplant.Results: Of the 82 participants who met the inclusion criteria, 16 patients sustained graft loss in 2 years since transplant, and a further 7 patients within 5. 20 patients without graft loss were selected as controls. 60% participants were from NT and 40% from SA. There were 3.5 median pre‐transplant admissions per control (inter‐quartile range (IQR) 1.5, 8) and 3 (2, 6) admissions per case and 5.5 median post‐transplant admissions per control (IQR 4, 9) and 7 (2, 15) per case. Infection related admissions accounted for 83 (19.3%) admission episodes pre‐transplant and 176 (29.3%) post‐transplant. CMV PCR was positive in 11(55%) of cases and controls. BK viraemia was detected in 5 (25%) controls and 7 (30%) cases. Odds ratio (OR) for graft loss and infection related admissions were similar in cases and controls in pre‐transplant period [OR 1.0, 95% confidence interval (CI) 0.1‐7.1]and in post‐transplant period 0.7 (95% CI 0.1‐4.0).Conclusion: This study highlights the high frequency of infection related admissions before and after transplantation. To date, these are not associated with graft and patient outcome.

AB - Introduction: Rates of graft failure and death related to infection are substantially higher among Indigenous transplant recipients. We explored detailed risk‐factors for graft and patient survival, beyond information available from the ANZDATA Registry.Methods: Case‐control study was conducted among indigenous transplant recipients in SA and NT 2005‐2015. Cases were those who received a kidney transplant and sustained graft loss (patient death or graft failure) within 5 years. Controls were matched (1:1) on time from transplantation and age. Medical records of participants were reviewed. Information was collected on hospital admissions and infections for 2 years pre and post kidney transplant.Results: Of the 82 participants who met the inclusion criteria, 16 patients sustained graft loss in 2 years since transplant, and a further 7 patients within 5. 20 patients without graft loss were selected as controls. 60% participants were from NT and 40% from SA. There were 3.5 median pre‐transplant admissions per control (inter‐quartile range (IQR) 1.5, 8) and 3 (2, 6) admissions per case and 5.5 median post‐transplant admissions per control (IQR 4, 9) and 7 (2, 15) per case. Infection related admissions accounted for 83 (19.3%) admission episodes pre‐transplant and 176 (29.3%) post‐transplant. CMV PCR was positive in 11(55%) of cases and controls. BK viraemia was detected in 5 (25%) controls and 7 (30%) cases. Odds ratio (OR) for graft loss and infection related admissions were similar in cases and controls in pre‐transplant period [OR 1.0, 95% confidence interval (CI) 0.1‐7.1]and in post‐transplant period 0.7 (95% CI 0.1‐4.0).Conclusion: This study highlights the high frequency of infection related admissions before and after transplantation. To date, these are not associated with graft and patient outcome.

KW - Urology & Nephrology

U2 - 10.1111/nep.13441

DO - 10.1111/nep.13441

M3 - Meeting Abstract

VL - 23

SP - 26

EP - 26

JO - Nephrology

JF - Nephrology

SN - 1320-5358

IS - S3

ER -