Retrospective case-control study exploring pre-transplant predictors for loss of kidney transplant function or death among Indigenous kidney transplant recipients

A retrospective case–control study was conducted, to identify risk factors for loss of kidney transplant function or death among the Indigenous kidney transplant recipients, beyond the information available from Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry.

Methods: Cases were defined as all Australian Indigenous kidney transplant recipients from 1st January 2005 to 31 December 2015 from the major hospitals in the Northern Territory (NT) and South Australia (SA) who experienced graft loss (including patient death) up to two-years post-transplant. Controls (matched 4:1) were defined as all Indigenous kidney transplant recipients during the same period with functioning transplants at two-years post-transplant operation. Matching was done on gender and diabetes status. Regression analysis adjusted for age was used for comparing cases and controls.

Results: There were 17 cases and 68 matched controls. Among cases, the odds ratio for more than one hospital admission episode (compared to ≤1 episode) in the two years pre-transplant period was 6.2 (95% CI, 1.2–32.5). However, there were no significant differences in the frequency of comorbidities at renal replacement therapy start, cardiovascular intervention pre-transplant, pre-transplant infection screening, age and gender of the donors, frequency of admission episodes where an infection was documented, the total length of inpatient stay or admission to intensive care unit during pre-transplant hospital admission between cases and controls.

Conclusion: Early graft loss was associated with a higher frequency of hospital admissions in the two-years pre-transplant period. In contrast, other measured factors in the pre-transplant period did not predict these adverse outcomes.