Elsevier

Transplantation Proceedings

Volume 48, Issue 1, January–February 2016, Pages 26-30
Transplantation Proceedings

Recent Advances in Transplantation
Kidney transplantation
Kidney Transplantation, Cardiovascular Risk, and Long-Term Dialysis in Japan

https://doi.org/10.1016/j.transproceed.2015.12.010Get rights and content
Under a Creative Commons license
open access

Highlights

  • We divided patients into 2 groups based on length of dialysis: Group A (<15 years) and Group B (≥15 years).

  • There were no significant differences between the groups in patient survival (P = .74) and graft survival (P = .72).

  • Cardiovascular event-free survival was significantly higher in Group A (P = .038).

Abstract

Background

The waiting time for deceased-donor kidney-only transplantations in Japan is long. Herein, we assessed the effect of length of dialysis on the outcomes of these patients.

Methods

We divided patients into 2 groups based on length of dialysis (Group A, <15 years, and Group B, ≥15 years), and compared the background and outcomes after kidney transplantation.

Results

Group A included 210 patients and Group B included 35 patients. In Group B, 20% of transplants were from living donors. Patient age (P = .017) and the hepatitis C infection rate (P = .018) were significantly higher in Group B, whereas hypertension (P = .011), diabetes (P = .041), and ABO-incompatibility rates (P = .015) were significantly higher in Group A. The 5- and 10-year survival rates were 97.0% and 95.4%, respectively, in Group A and 97.1% and 97.1%, respectively, in Group B. The 5- and 10-year graft survival rates were 95.4% and 84.8%, respectively, in Group A and 97.1% and 73.1%, respectively, in Group B. There were no significant differences between the groups in patient survival (P = .74) and graft survival (P = .72). The 5- and 10-year cardiovascular event-free survival rates were 95.9% and 92.4%, respectively, in Group A and 88.6% and 76.8%, respectively, in Group B. Cardiovascular event-free survival was significantly higher in Group A (P = .038). Cox stepwise multivariate analysis indicated that length of dialysis was a significant predictor of cardiovascular events (hazard risk, 1.007; range, 1.001–1.012; P = .012).

Conclusion

The prognosis after kidney transplantation is promising even after a long length of dialysis, although evaluation of the cardiovascular risk is needed in these cases.

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