Author(s)
Riah Lee (student)1
Raj Patel (student)1
Jennie Dworkin (student)1
Matthew Cullen (Student)2
Yang Yu MPP(faculty)3
Meng-Hao Li PhD(faculty)3
Geovanni Faddoul MD (faculty)2
Naoru Koizumi PhD (faculty)3
Jorge Ortiz MD (faculty)4
Affiliation(s)
1 Touro College of Osteopathic Medicine, Middletown, NY; 2 Albany Medical College, Albany, NY; 3 George Mason University Fairfax, VA; 4 Garnet Health Medical Center, Department of Surgery, Middletown, NY;
Abstract:
Introduction: Despite advancements in organ procurement, immunosuppression regimens and prophylactic antibiotic therapies, early graft loss (EGL) remains a challenge in kidney transplantation. We aim to identify risk factors associated with 7-day graft loss (7DGL) and factors influencing 1-year graft survival.
Methods: An IRB-exempt retrospective analysis (Jan 1st, 2015 - Jun 30th, 2024) was performed using the United Network for Organ Sharing (UNOS) database. We analyzed risk factors for live-donor (LD) kidney recipients who experienced 7DGL with those who maintained graft survival for at least 1 year.
Results: 7DGL occurred in 54 (0.14%) of 38,846 kidney recipients from LD. Primary risk factors were older donor age (OR:1.026, p=0.021), FSGS (OR:2.581, p=1.209) and modern transplant era (OR:1.976, p=0.017). Graft thrombosis (p<0.001), technical complication (p=0.014) and recurrent disease ( p=0.032) were the predominant causes of 7DGL. The combination induction therapy (ATG + IL2) significantly increased the odds of 7DGL (OR:3.859, p=0.012).
Conclusion: The key risk factors associated with 7DGL from LD were donor age, FSGS, modern transplant era and dialysis vintage. The primary causes of 7DGL included graft thrombosis, technical complications and recurrent diseases and unknown causes. These findings emphasize the need for closer recipient monitoring and improved donor selection strategies to enhance overall transplant outcomes.