Assessing the influence of graft loss on 4-year patient survival after simultaneous pancreas-kidney transplantation: Kaplan–Meier versus Competing Risk Analysis model

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MetadadosDescriçãoIdioma
Autor(es): dc.contributorFundação Oswaldo Ramos-
Autor(es): dc.contributorUniversidade Federal de São Paulo (UNIFESP)-
Autor(es): dc.contributorUniversidade Estadual Paulista (UNESP)-
Autor(es): dc.creatorAlfaro Villanueva, Lucia Alejandra-
Autor(es): dc.creatorJunior, Roberto Meirelles-
Autor(es): dc.creatorRangel, Érika Bevilaqua-
Autor(es): dc.creatorModelli, Luis Gustavo-
Autor(es): dc.creatorViana, Laila Almeida-
Autor(es): dc.creatorCristelli, Marina Pontello-
Autor(es): dc.creatorRequião-Moura, Lúcio-
Autor(es): dc.creatorForesto, Renato Demarchi-
Autor(es): dc.creatorTedesco-Silva, Helio-
Autor(es): dc.creatorPestana, José Medina-
Data de aceite: dc.date.accessioned2025-08-21T20:49:41Z-
Data de disponibilização: dc.date.available2025-08-21T20:49:41Z-
Data de envio: dc.date.issued2025-04-29-
Data de envio: dc.date.issued2024-04-01-
Fonte completa do material: dc.identifierhttp://dx.doi.org/10.1111/ctr.15298-
Fonte completa do material: dc.identifierhttps://hdl.handle.net/11449/309847-
Fonte: dc.identifier.urihttp://educapes.capes.gov.br/handle/11449/309847-
Descrição: dc.descriptionBackground: Graft loss increases the risk of patient death after simultaneous pancreas-kidney (SPK) transplantation. The relative risk of each graft failure is complex due to the influence of several competing events. Methods: This retrospective, single-center study compared 4-year patient survival according to the graft status using Kaplan-Meier (KM) and Competing Risk Analysis (CRA). Patient survival was also assessed according to five eras (Era 1: 2001–2003; Era 2: 2004–2006; Era 3: 2007–2009; Era 4: 2010–2012; Era 5: 2012–2015). Results: Between 2000 and 2015, 432 SPK transplants were performed. Using KM, patient survival was 86.5% for patients without graft loss (n = 333), 93.4% for patients with pancreas graft loss (n = 46), 43.7% for patients with kidney graft loss (n = 16), and 25.4% for patients with pancreas and kidney graft loss (n = 37). Patient survival was underestimated using KM versus CRA methods in patients with pancreas and kidney graft losses (25.4% vs. 36.2%), respectively. Induction with lymphocyte depleting antibodies was associated with 81% reduced risk (HR.19, 95% CI.38–.98, p =.0048), while delayed kidney function (HR 2.94, 95% CI 1.09–7.95, p =.033) and surgical complications (HR 2.94, 95% CI 1.22–7.08, p =.016) were associated with higher risk of death. Four-year patient survival increased from Era 1 to Era 5 (79% vs. 87.9%, p =.047). Conclusion: In this cohort of patients, kidney graft loss, with or without pancreas graft loss, was associated with higher mortality after SPK transplantation. Compared to CRA, the KM model underestimated survival only among patients with pancreas and kidney graft losses. Patient survival increased over time.-
Descrição: dc.descriptionHospital do Rim Fundação Oswaldo Ramos-
Descrição: dc.descriptionNephrology Division Universidade Federal de São Paulo-
Descrição: dc.descriptionDivision of Nephrology Department of Internal Medicine Universidade Estadual Paulista (UNESP)-
Descrição: dc.descriptionDivision of Nephrology Department of Internal Medicine Universidade Estadual Paulista (UNESP)-
Idioma: dc.languageen-
Relação: dc.relationClinical Transplantation-
???dc.source???: dc.sourceScopus-
Palavras-chave: dc.subjectCompeting Risk Analysis Model-
Palavras-chave: dc.subjectKaplan-Meier method-
Palavras-chave: dc.subjectkidney graft loss-
Palavras-chave: dc.subjectpancreas graft loss-
Palavras-chave: dc.subjectrecipient survival-
Palavras-chave: dc.subjectSimultaneous pancreas-kidney transplantation-
Título: dc.titleAssessing the influence of graft loss on 4-year patient survival after simultaneous pancreas-kidney transplantation: Kaplan–Meier versus Competing Risk Analysis model-
Tipo de arquivo: dc.typelivro digital-
Aparece nas coleções:Repositório Institucional - Unesp

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