Long-term outcomes and prognostic factors in kidney transplant recipients in Jakarta, Indonesia: a cohort study
Objectives To determine the long-term survival rates and prognostic factors in kidney transplant (KT) recipients in Jakarta, Indonesia.Design Retrospective cohort study.Setting A KT centre in Jakarta.Participants We enrolled 754 consecutive adult recipients who underwent KT between 2010 and 2020.Mai...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2022-05-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/5/e059631.full |
| _version_ | 1798002642808471552 |
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| author | Utami Susilowati Maruhum Bonar H Marbun Endang Susalit Tantika Andina |
| author_facet | Utami Susilowati Maruhum Bonar H Marbun Endang Susalit Tantika Andina |
| author_sort | Utami Susilowati |
| collection | DOAJ |
| description | Objectives To determine the long-term survival rates and prognostic factors in kidney transplant (KT) recipients in Jakarta, Indonesia.Design Retrospective cohort study.Setting A KT centre in Jakarta.Participants We enrolled 754 consecutive adult recipients who underwent KT between 2010 and 2020.Main outcome measures Rates of 10-year patient, all-cause and death-censored graft survival and their prognostic factors in KT recipients.Results The 10-year patient survival, all-cause survival and death-censored graft survival rates of KT recipients were 74%, 68% and 81%, respectively. The prognostic factors for poor patient survival were a pretransplant dialysis duration>24 months (HR 1.64, 95% CI, 1.08 to 2.49; p=0.02), cardiovascular disease (HR 1.59, 95% CI, 1.11 to 2.31; p=0.01), delayed graft function (DGF) (HR 4.94, 95% CI, 2.76 to 8.82; p<0.001), post-transplant infection (HR 2.63, 95% CI, 1.56 to 4.43; p<0.001) and acute rejection (HR 2.49, 95% CI, 1.20 to 5.15; p=0.01). All-cause graft survival was prognosticated by a pretransplant dialysis duration>24 months (HR 1.74, 95% CI, 1.15 to 2.47; p=0.007), cardiovascular disease (HR 1.65, 95% CI, 1.18 to 2.33; p=0.004), DGF (HR 5.39, 95% CI, 3.13 to 9.28; p<0.001), post-transplant infection (HR 2.46, 95% CI, 1.05 to 4.02; p<0.001) and acute rejection (HR 4.18, 95% CI, 2.23 to 7.84; p<0.001). Factors associated with poor death-censored graft survival were a pretransplant dialysis duration >24 months (HR 2.19, 95% CI, 1.32 to 3.63; p=0.002), cardiovascular disease (HR 1.65, 95% CI, 1.02 to 2.68; p=0.04) and acute rejection (HR 5.52, 95% CI, 2.80 to 10.83; p<0.001).Conclusions The survival rates of KT recipients are prognosticated by pretransplant dialysis duration, cardiovascular disease, DGF, post-transplant infection and acute rejection. Stricter eligibility criteria for recipients, more sensitive cross-match testing methods and better infection management strategies may be beneficial for improving the survival rates. |
| first_indexed | 2024-04-11T11:55:24Z |
| format | Article |
| id | doaj.art-ae5c14f4e14447bfbc3b391a69b00224 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-04-11T11:55:24Z |
| publishDate | 2022-05-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-ae5c14f4e14447bfbc3b391a69b002242022-12-22T04:25:10ZengBMJ Publishing GroupBMJ Open2044-60552022-05-0112510.1136/bmjopen-2021-059631Long-term outcomes and prognostic factors in kidney transplant recipients in Jakarta, Indonesia: a cohort studyUtami Susilowati0Maruhum Bonar H Marbun1Endang Susalit2Tantika Andina3Department of Internal Medicine, Rumah Sakit Umum Pusat Nasional Dr Cipto Mangunkusumo, Central Jakarta, DKI Jakarta, IndonesiaDivision of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, IndonesiaDivision of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, IndonesiaDivision of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, IndonesiaObjectives To determine the long-term survival rates and prognostic factors in kidney transplant (KT) recipients in Jakarta, Indonesia.Design Retrospective cohort study.Setting A KT centre in Jakarta.Participants We enrolled 754 consecutive adult recipients who underwent KT between 2010 and 2020.Main outcome measures Rates of 10-year patient, all-cause and death-censored graft survival and their prognostic factors in KT recipients.Results The 10-year patient survival, all-cause survival and death-censored graft survival rates of KT recipients were 74%, 68% and 81%, respectively. The prognostic factors for poor patient survival were a pretransplant dialysis duration>24 months (HR 1.64, 95% CI, 1.08 to 2.49; p=0.02), cardiovascular disease (HR 1.59, 95% CI, 1.11 to 2.31; p=0.01), delayed graft function (DGF) (HR 4.94, 95% CI, 2.76 to 8.82; p<0.001), post-transplant infection (HR 2.63, 95% CI, 1.56 to 4.43; p<0.001) and acute rejection (HR 2.49, 95% CI, 1.20 to 5.15; p=0.01). All-cause graft survival was prognosticated by a pretransplant dialysis duration>24 months (HR 1.74, 95% CI, 1.15 to 2.47; p=0.007), cardiovascular disease (HR 1.65, 95% CI, 1.18 to 2.33; p=0.004), DGF (HR 5.39, 95% CI, 3.13 to 9.28; p<0.001), post-transplant infection (HR 2.46, 95% CI, 1.05 to 4.02; p<0.001) and acute rejection (HR 4.18, 95% CI, 2.23 to 7.84; p<0.001). Factors associated with poor death-censored graft survival were a pretransplant dialysis duration >24 months (HR 2.19, 95% CI, 1.32 to 3.63; p=0.002), cardiovascular disease (HR 1.65, 95% CI, 1.02 to 2.68; p=0.04) and acute rejection (HR 5.52, 95% CI, 2.80 to 10.83; p<0.001).Conclusions The survival rates of KT recipients are prognosticated by pretransplant dialysis duration, cardiovascular disease, DGF, post-transplant infection and acute rejection. Stricter eligibility criteria for recipients, more sensitive cross-match testing methods and better infection management strategies may be beneficial for improving the survival rates.https://bmjopen.bmj.com/content/12/5/e059631.full |
| spellingShingle | Utami Susilowati Maruhum Bonar H Marbun Endang Susalit Tantika Andina Long-term outcomes and prognostic factors in kidney transplant recipients in Jakarta, Indonesia: a cohort study BMJ Open |
| title | Long-term outcomes and prognostic factors in kidney transplant recipients in Jakarta, Indonesia: a cohort study |
| title_full | Long-term outcomes and prognostic factors in kidney transplant recipients in Jakarta, Indonesia: a cohort study |
| title_fullStr | Long-term outcomes and prognostic factors in kidney transplant recipients in Jakarta, Indonesia: a cohort study |
| title_full_unstemmed | Long-term outcomes and prognostic factors in kidney transplant recipients in Jakarta, Indonesia: a cohort study |
| title_short | Long-term outcomes and prognostic factors in kidney transplant recipients in Jakarta, Indonesia: a cohort study |
| title_sort | long term outcomes and prognostic factors in kidney transplant recipients in jakarta indonesia a cohort study |
| url | https://bmjopen.bmj.com/content/12/5/e059631.full |
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