Kidney Week

Abstract: TH-PO771

Trends in 1-Year Outcomes among Kidney Transplant Recipients, by Time since Transplant

Session Information

• Transplantation: Clinical - 1
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2102 Transplantation: Clinical

Authors

• Gilbertson, David T., Chronic Disease Research Group, Hennepin Healthcare Research Institute, Minneapolis, Minnesota, United States

David T. Gilbertson, PhD

• Wetmore, James B., Chronic Disease Research Group, Hennepin Healthcare Research Institute, Minneapolis, Minnesota, United States

James B. Wetmore, MD, MS

• Liu, Jiannong, Chronic Disease Research Group, Hennepin Healthcare Research Institute, Minneapolis, Minnesota, United States

Jiannong Liu, PhD

• Roetker, Nicholas S., Chronic Disease Research Group, Hennepin Healthcare Research Institute, Minneapolis, Minnesota, United States

Nicholas S. Roetker, MS, PhD

• Johansen, Kirsten L., Chronic Disease Research Group, Hennepin Healthcare Research Institute, Minneapolis, Minnesota, United States

Kirsten L. Johansen, MD, FASN

Background

Trends in 1- and 5-year outcomes after kidney transplant (KTx) have improved over the last 20 years, trends that could be driven in part by increasing prevalence of long-term KTx survivors over time. We examined trends in rates of 1-year death and graft loss among KTx recipients, overall and by time since KTx.

Methods

We selected point prevalent deceased-donor KTx recipients on Jan 1 of each year, 2000-2019. In each cohort, we examined 1-year death and death-censored graft loss rates. We estimated unadjusted and adjusted rates overall and by time since KTx. Adjustors were age, sex, race, ESKD cause and pre-KTx dialysis vintage.

Results

Before adjustment, patient survival showed little change over time, whereas adjusted analyses show improvement (Fig 1). Death-censored graft loss improved over time, regardless of adjustment. Fig 2 shows adjusted 1-year death (top) and graft loss (bottom) rates by time since KTx, for 2000, 2010 and 2019. After 2 years post-KTx, death and graft loss rates increased by time since transplant, as expected. However, rates of both outcomes were lower in 2010 and 2019 relative to 2000, irrespective of the years since transplant.

Conclusion

Adjusted rates of death and death-censored graft loss in the year following KTx have improved over time, an important finding given that older patients and those with more comorbidities are now more likely to receive a KTx than in the past. Adjusted outcomes are better in 2019 than in 2000, irrespective of the time since KTx.

Funding

• NIDDK Support