Analysis Of The Related Factors Affecting Kidney Graft Failure And Death Of Kidney Transplant Recipients

Objective:To analyze the influencing factors of graft failure and recipient death after allogeneic kidney transplantation in patients with end-stage renal disease,in order to provide theoretical and practical basis for prolonging the survival time of transplanted kidney and recipients after kidney transplantation.Methods:The clinical data of patients who underwent allogeneic kidney transplantation from January 1,2011 to December 31,2020 in the First Hospital of Jilin University and were regularly followed up for 1 year or more were collected,and the gender,age,and body mass index of the donors were retrospectively analyzed.Donation type,cold ischemia time,warm ischemia time,Remuzzi score and MAPI score of pathology report for kidney graft biopsy at zero time point,,recipient gender,age,body mass index,preoperative dialysis method,dialysis duration,primary disease,hypertension,diabetes,hepatitis B virus,hepatitis C virus,immune induction therapy,delayed graft function（DGF）,acute rejection（AR）,infection and other factors,COX regression model was used for univariate and multivariate statistical analysis,and the independent risk factors for graft failure and recipient death after kidney transplantation were obtained.Result:Among the 1534 patients who received kidney transplantation,the follow-up time was 46.4±26.7 months,of which 96 cases of transplanted kidney lost function,and the transplanted kidney failure rate was 6.3%,54 kidney transplant recipients died,and the recipient mortality rate was 3.5 %.The study showed that recipient of diabetes（P=0.022）,hepatitis C virus infection（P=0.031）,donor age（P=0.010）,DGF（P<0.001）,AR（P<0.001）,infection（P<0.001）)had a significant effect on graft failure;recipient age（P<0.001）,diabetes mellitus（P=0.010）,duration of dialysis（P=0.010）,donation type（P=0.009）,donor age（0.002）,infection（P<0.001）,DGF（P<0.001）,AR（P=0.013）,and donor kidney cold ischemia time（P=0.016）had significant effects on the death of recipients.Among them,recipient diabetes（P=0.046）,donor age（P=0.005）,DGF（P<0.001）,AR（P<0.001）,and infection（P<0.001）were independent risk factors for graft failure.The age of the recipient（P=0.026）,the age of the donor（P=0.003）,DGF（P<0.001）,and infection（P<0.001）were independent risk factors for the death of the recipient.Conclusion:（1）Recipient diabetes,hepatitis C virus,donor age,DGF,AR,and infection are the influencing factors of graft failure;recipient age,diabetes,duration of dialysis,donation type,donor age,infection,DGF,AR and donor kidney cold ischemia time were the influencing factors of recipient death.（2）Recipient diabetes,donor age,DGF,AR,and infection were independent risk factors for graft failure;donor age,recipient age,infection,and DGF were independent risk factors for recipient death.