The modifiable non-immunological prognostic factors for medium-term kidney transplant outcomes

Joanna Stępniewska, Krzysztof Pabisiak, Krzysztof Safranow, Jadwiga Grabowska, Kazimierz Ciechanowski

Abstract


Introduction: Current management of patients after kidney transplantation focuses on medium- and long-term graft survival. The lack of new immunomodulatory agents available for routine use in immunosuppressive therapy has led to slow progress in reducing late allograft loss rates. This has drawn attention to non-immunological factors that influence the maintenance of transplanted kidney function.
Materials and methods: This retrospective study reviewed the characteristics of 191 kidney transplant recipients and 191 deceased donors from a single center. The analysis evaluated the influence of donor-related factors (age, cause of death, last plasma creatinine concentration, and duration of intensive care unit stay) and recipient-related factors (gender, age, time from initiation of dialysis, cause of chronic kidney disease, number of prior kidney transplantations, and cold ischaemia time – CIT) on graft function and survival. Outcomes were assessed by the incidence of primary non-function, delayed graft function, plasma creatinine concentration on day 30 and at 6, 12, 24, 36, and 60 months post-transplant, early (within the first year) or late recipient death, and early graft explantation.
Results: Significant donor-dependent risk factors included older donor age and cerebrovascular accident as the cause of death. Recipient-dependent risk factors included older recipient age, male gender, and a higher number of prior kidney transplantations. According to the Cox proportional hazards model, each additional hour of CIT increased the risk of graft loss by 7%, and each additional year on haemodialysis increased the risk by 12%.
Conclusions: Cold ischaemia time and duration of dialysis treatment are significant modifiable non-immunological factorsinfluencing medium-term kidney transplant outcomes. Efforts to reduce these factors may improve transplantation results.

Keywords


kidney transplantation; transplant outcomes; chronic kidney disease; haemodialysis; cold ischaemia time.

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References


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DOI: https://doi.org/10.21164/pomjlifesci.1090

Copyright (c) 2025 Joanna Stępniewska, Krzysztof Pabisiak, Krzysztof Safranow, Jadwiga Grabowska, Kazimierz Ciechanowski

License URL: https://creativecommons.org/licenses/by-nc-nd/3.0/pl/