Transplantation of non-renal organs may be complicated by chronic renal disease with a number of causes.
In this study, a team of scientists from the United States performed a population-based cohort analysis to evaluate the incidence of chronic renal failure in non-renal transplant recipients. They assessed the risk factors for renal failure and calculated the associated hazard of death.
The team evaluated pre- and post-transplantation clinical variables, as well as data from a registry of patients with end-stage renal disease. These data were linked to enable the estimation of the cumulative incidence of chronic renal failure and the associated risk of death.
They included the data for 69,321 patients who received non-renal transplants.
|5-year risk of chronic renal failure was 21% in intestine transplant recipients.|
|New England Journal of Medicine|
The researchers found that, during a median follow-up of 36 months, chronic renal failure developed in 17% of patients. Of these patients, 29% required maintenance dialysis or renal transplantation.
The team determined that the 5-year risk of chronic renal failure varied according to the type of organ transplanted. This risk was 7% among heart–lung transplant recipients and 21% in intestine transplant recipients.
Furthermore, multivariate analysis found that an increased risk of chronic renal failure was associated with increasing age, female sex, pre-transplantation hepatitis C infection, diabetes mellitus, and postoperative acute renal failure.
The researchers determined that the occurrence of chronic renal failure significantly increased the risk of death in transplant recipients.
Dr Akinlolu Ojo's team concluded, "The 5-year risk of chronic renal failure after transplantation of a non-renal organ ranges from 7 to 21%, depending on the type of organ transplanted".
"The occurrence of chronic renal failure among patients with a non-renal transplant is associated with an increase by a factor of more than 4 in the risk of death".