Estimated One-Year Glomerular Filtration Rate is the Best Predictor of Long-term Graft Function Following Renal Transplant
- 1 January 2006
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Transplantation
- Vol. 81 (2), 202-206
- https://doi.org/10.1097/01.tp.0000188135.04259.2e
Abstract
Long-term success of renal transplantation depends upon the quality of the donor organ, avoidance of peritransplant and early posttransplant damage (rejection), and optimal maintenance of graft function after the first 6–12 months. Glomerular filtration rate (GFR) at 1 year is a standard way to evaluate short-term success, whereas calculated GFR at 5 years gives a better appreciation of long-term outcomes. The objective of this study was to assess the effect of various demographic and transplant-related parameters on renal function via GFR at 1 year and 5 years post transplantation, using univariate and multivariate data analysis. Data on 1-year GFR were available from 10,397 patients, whereas 2,889 patients provided data on both 1-year and 5-year GFR. All patients were enrolled in the Neoral Multinational Observational Study in Transplantation (Neoral-MOST), an ongoing, prospective, observational study of adult renal transplant recipients. One-year GFR was the most relevant predictor for 5-year GFR. In a multifactorial analysis (ANCOVA) using 1-year GFR as a continuous variable, the effects of several highly relevant parameters from univariate analysis (such as acute rejection and delayed graft function) on 5-year GFR appeared to be fully mediated by their influence on 1-year GFR, whereas immunological risk factors like HLA match or previous transplantation had an ongoing effect on graft function beyond year 1. The findings of this study corroborate and augment data from previous registry surveys, and confirm the importance of observational studies in investigating the role of peritransplant parameters on long-term graft outcome.This publication has 19 references indexed in Scilit:
- Patient and graft outcomes from older living kidney donors are similar to those from younger donors despite lower GFRKidney International, 2004
- Diminishing Significance of HLA Matching in Kidney TransplantationAmerican Journal of Transplantation, 2004
- High Pretransplant Serum Levels of CXCL10/IP-10 Are Related to Increased Risk of Renal Allograft FailureAmerican Journal of Transplantation, 2004
- Surrogate Markers for Long-Term Renal Allograft SurvivalAmerican Journal of Transplantation, 2004
- Similar risk profiles for post-transplant renal dysfunction and long-term graft failure: UNOS/OPTN database analysisKidney International, 2004
- Impact of cadaveric renal donor morbidity on long-term graft functionTransplant International, 2003
- Ten-year survival of second kidney transplants: Impact of immunologic factors and renal function at 12monthsKidney International, 2003
- Post-transplant renal function in the first year predicts long-term kidney transplant survivalKidney International, 2002
- LONG-TERM RESULTS OF RENAL TRANSPLANTATION IN RECIPIENTS WITH A FUNCTIONING GRAFT FOR 2 YEARSTransplantation, 1982
- Prediction of Creatinine Clearance from Serum CreatinineNephron, 1976