Title
Ineligibility for renal transplantation: prevalence, causes and survival in a consecutive cohort of 445 patientsIneligibility for renal transplantation: prevalence, causes and survival in a consecutive cohort of 445 patients
Author
Faculty/Department
Faculty of Medicine and Health Sciences
Publication type
article
Publication
New York,
Subject
Human medicine
Source (journal)
Clinical transplantation. - New York
Volume/pages
25(2011):4, p. 576-583
ISSN
0902-0063
ISI
000293919100023
Carrier
E
Target language
English (eng)
Full text (Publishers DOI)
Abstract
Little is known about the proportion of renal transplant candidates who are considered ineligible by the transplant center, the reasons of their ineligibility and their survival during dialysis. In this retrospective, single-center study of 445 adult patients referred between 2001 and 2006, 36 (8%) were deemed ineligible for medical contraindications. The leading reason was cardiovascular (CV) (75%), specifically aorto-iliac, and/or limb vessels atheromatosis or calcifications; ischemic heart disease; or a combination thereof. Nine patients had other contraindications that were absolute for three of them; six patients displayed a combination of relative contraindications. When compared to eligible patients (N = 409), those ineligible were significantly older (60 yr vs. 48), more often diabetics (50% vs. 15%), obese (39% vs. 17%) suffering from coronary artery disease (53% vs. 11%) and peripheral arterial disease (86% vs. 11%). Their primary nephropathy was more often diabetic and/or hypertensive/nephroangiosclerosis (61% vs. 23%), and their median dialysis vintage prior to evaluation was longer (29 months vs. 10, p < 0.0001). The actuarial survival of ineligible patients was significantly lower than that of eligible patients (at five yr: 53% vs. 88%). Adequate control of CV risk factors before dialysis and early referral for transplantation might help to improve eligibility of renal transplant candidates.
E-info
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