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Research
Xianding Wang
Sichuan University West China Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0003-0113-0395
License:
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Background
Deceased donor kidney transplantation is an important therapeutic option for end-stage renal diseases. Adverse events including acute rejection after deceased donor kidney transplantation are not uncommon and result in poor transplant outcomes. Exploration of risk factors and patient stratification is increasingly significant to improve graft survival. This study aim to evaluate and identify the risk factors for treated rejection of patients after deceased donor kidney transplantation.
Methods
Clinical and immunological data of deceased donors and corresponding recipients between 2015 and 2018 in West China Hospital were retrospectively collected. The Kolmogorov-Smirnov test was used to indicate distribution of variables. Univariate comparisons of baseline characteristics were made with Chi-square, t and Mann-Whitney U tests. Logistic regression was constructed to analysis potential risk factors. Receiver operating characteristic curve and Jordan index were generated to determine optimal cut-off value for continuous variables.
Results
Data of 123 deceased donors and 246 recipients were obtained. The median (range) age was 41(4–62) years in recipients and 39 (1–65) years in donors. The recipients who died or suffered graft loss during the follow-up period were 8 (3.3%) and 12 (4.9%) respectively. After univariate analysis and subsequent multivariate analysis, some preoperative hemato-biochemical and transplantation-related parameters including uric acid (HR 2.132, 95%CI: 1.016–4.476, P = 0.045), platelet (HR 2.202, 95%CI:1.051–4.617, P = 0.037), absolute neutrophil count (HR 2.164, 95%CI:1.018–4.599, P = 0.045) and HLA-DQ mismatch (HR 2.197, 95%CI:1.119–4.317, P = 0.022) showed statistical significance and could be considered as independent predictors for treated rejection.
Conclusions
Including unexpected serum uric acid, several hemato-biochemical and transplantation-related parameters were found to be independent risk factors for rejection, which may contribute to stratify patients and develop personalized regimen in perioperative period.
Keywords
kidney transplantation, donor, recipient, rejection, risk factor
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A new preprint design is coming!
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This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research
Xianding Wang
Sichuan University West China Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0003-0113-0395
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 16 Feb, 2021
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Translational Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Deceased donor kidney transplantation is an important therapeutic option for end-stage renal diseases. Adverse events including acute rejection after deceased donor kidney transplantation are not uncommon and result in poor transplant outcomes. Exploration of risk factors and patient stratification is increasingly significant to improve graft survival. This study aim to evaluate and identify the risk factors for treated rejection of patients after deceased donor kidney transplantation.
Methods
Clinical and immunological data of deceased donors and corresponding recipients between 2015 and 2018 in West China Hospital were retrospectively collected. The Kolmogorov-Smirnov test was used to indicate distribution of variables. Univariate comparisons of baseline characteristics were made with Chi-square, t and Mann-Whitney U tests. Logistic regression was constructed to analysis potential risk factors. Receiver operating characteristic curve and Jordan index were generated to determine optimal cut-off value for continuous variables.
Results
Data of 123 deceased donors and 246 recipients were obtained. The median (range) age was 41(4–62) years in recipients and 39 (1–65) years in donors. The recipients who died or suffered graft loss during the follow-up period were 8 (3.3%) and 12 (4.9%) respectively. After univariate analysis and subsequent multivariate analysis, some preoperative hemato-biochemical and transplantation-related parameters including uric acid (HR 2.132, 95%CI: 1.016–4.476, P = 0.045), platelet (HR 2.202, 95%CI:1.051–4.617, P = 0.037), absolute neutrophil count (HR 2.164, 95%CI:1.018–4.599, P = 0.045) and HLA-DQ mismatch (HR 2.197, 95%CI:1.119–4.317, P = 0.022) showed statistical significance and could be considered as independent predictors for treated rejection.
Conclusions
Including unexpected serum uric acid, several hemato-biochemical and transplantation-related parameters were found to be independent risk factors for rejection, which may contribute to stratify patients and develop personalized regimen in perioperative period.
This is a list of supplementary files associated with this preprint. Click to download.
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