A RETROSPECTIVE CASE-CONTROL STUDY EXPLORING RISK FACTORS FOR LOSS OF KIDNEY TRANSPLANT FUNCTION OR DEATH AMONG INDIGENOUS TRANSPLANT RECIPIENTS

N KHANAL1,2,  P LAWTON3, A CASS3, S MCDONALD1,2
1University Of Adelaide, , , 2Central and Northern Adelaide Renal Transplantation Services, Royal Adelaide Hospital, , , 3Menzies School of Health Research, Charles Darwin University,

Introduction: Rates of graft failure and death related to infection are substantially higher among Indigenous transplant recipients. We explored detailed risk-factors for graft and patient survival, beyond information available from the ANZDATA Registry.
Methods: Case-control study was conducted among indigenous transplant recipients in SA and NT 2005-2015. Cases were those who received a kidney transplant and sustained graft loss (patient death or graft failure) within 5 years. Controls were matched (1:1) on time from transplantation and age. Medical records of participants were reviewed. Information was collected on hospital admissions and infections for 2 years pre and post kidney transplant.
Results: Of the 82 participants who met the inclusion criteria, 16 patients sustained graft loss in 2 years since transplant, and a further 7 patients within 5. 20 patients without graft loss were selected as controls. 60% participants were from NT and 40% from SA. There were 3.5 median pre-transplant admissions per control (inter-quartile range (IQR) 1.5, 8) and 3 (2, 6) admissions per case and 5.5 median post-transplant admissions per control (IQR 4, 9) and 7 (2, 15) per case. Infection related admissions accounted for 83 (19.3%) admission episodes pre-transplant and 176 (29.3%) post-transplant. CMV PCR was positive in 11(55%) of cases and controls. BK viraemia was detected in 5 (25%) controls and 7 (30%) cases. Odds ratio (OR) for graft loss and infection related admissions were similar in cases and controls in pre-transplant period [OR 1.0, 95% confidence interval (CI) 0.1-7.1]and in post-transplant period 0.7 (95% CI 0.1-4.0).
Conclusion: This study highlights the high frequency of infection related admissions before and after transplantation. To date, these are not associated with graft and patient outcome.


Biography:
Dr. Namrata Khanal is PhD candidate and Nephrologist from Adelaide, SA.

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