Multivariate Analysis Applied In The Follow-up System Of Renal Transplantation

Objective:Application of unconditional multivariate Logistic regression to explore the factors of delayed graft function recovery and acute rejection in the recipient of renal transplantation after operation, this study compared the efficacy and safety of monoclonal antibody of anti-interleukin-2receptor and polyclonal anti-lymphocyte-antibody with Cox proportional hazards regression analysis, to explore whether they can reduce the acute rejection and improve the survival of donor and recipient.Methods:This study collected Chinese Scientific Registry of Kidney Transplantation (CSRKT), the data of1104recipients who received renal transplantation during January2007to December2011in the309th hospital of PLA were pre-processed according to the inclusion criteria of this study. Finally,810of the recipients who were included in the analysis of delayed graft function recovery and acute rejection,200of the recipients who were included in the analysis of antibody induction therapy in the prevention of acute rejection were analyzed. The data of delayed graft function recovery group and acute rejection group were analyzed with the single chi-square test and multifactor logistic regression analysis. The acute rejection incidence、graft dysfunction and infection complication rate of two groups of different antibody induction therapy were analyzed with multifactor Cox regression analysis.Result:The incidence of DGF was24.2%(196/810). The age of recipient, donor, the type of transplantation, cold and hot ischemia time, transplantation times were significantly associated with DGF in terms of the single factor. Multiple factors stepwise logistic regression analysis showed that the age of donor, the type of transplantation, cold and hot ischemia time, transplantation times were the risk factors of DGF. Their dominance ratios were1.783,6.760,2.437,1.520,3.758. The incidence of AR was17.2%(139/810). The age and gender of donor, the type of transplantation, cold and hot ischemia time, transplantation times, induction therapy and DGF were significantly associated with AR in terms of the single factor. Multiple factors Cox regression analysis showed that the type of transplantation, cold ischemia time, induction therapy and DGF were the risk factors of AR. Their dominance ratios were1.568,1.493,1.709,2.521. The difference of the acute rejection incidence、graft dysfunction and infection complication rate between two groups of different antibody induction therapy(IL-2RA and anti-Lym-Ab) has no significant. The risk factor of graft dysfunction is the age of donor. The risk factor of infection complication is the age of recipient.Conclusions:Analysis of multiple factors unconditional Logistic regression and Cox proportional hazards regression model can be better applied to the study. It is very important from clinical perspective to analyze and understand the risk factors of DGF and AR thoroughly in order to prevent them effectively. The difference of the acute rejection incidence、graft dysfunction and infection complication rate between two groups of different antibody induction therapy(IL-2RA and anti-Lym-Ab) was not proved in this study.