Organization of Post-Transplant Care and the 5-Year Outcomes of Kidney Transplantation

Agnieszka Szymańska, Krzysztof Mucha, Maciej Kosieradzki, Sławomir Nazarewski, Leszek Pączek and Bartosz Foroncewicz
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Agnieszka Szymańska: Department of Immunology, Transplantology and Internal Diseases, Medical University of Warsaw, 02-091 Warsaw, Poland
Krzysztof Mucha: Department of Immunology, Transplantology and Internal Diseases, Medical University of Warsaw, 02-091 Warsaw, Poland
Maciej Kosieradzki: Department of General and Transplantation Surgery, Medical University of Warsaw, 02-091 Warsaw, Poland
Sławomir Nazarewski: Department of General, Vascular and Transplant Surgery, Medical University of Warsaw, 02-091 Warsaw, Poland
Leszek Pączek: Department of Immunology, Transplantology and Internal Diseases, Medical University of Warsaw, 02-091 Warsaw, Poland
Bartosz Foroncewicz: Department of Immunology, Transplantology and Internal Diseases, Medical University of Warsaw, 02-091 Warsaw, Poland

IJERPH, 2022, vol. 19, issue 4, 1-12

Abstract: The outcomes of kidney transplantation depend on numerous factors and vary between transplant centers. The aim of this study is to assess the relationship between selected organizational factors, comorbidities, and patient and graft survival. This is a retrospective analysis of 438 renal transplant recipients (RTR) followed for 5 years. Patient and graft survival were evaluated in relation to hospitalization length, distance from the patient’s residence to the transplant center, the frequency of outpatient transplant visits, and the number and type of comorbidities. Five-year patient and graft survival rates were 93% and 90%, respectively. We found significant associations of patient survival with the prevalence of pre-transplant diabetes, cardiovascular diseases, malignancies, the number of comorbidities, and the first post-transplant hospitalization length. The incidence of infections, cardiovascular diseases, and transplanted kidney diseases was 60%, 40%, and 33%, respectively. As many as 41% of RTR had unknown etiology of primary kidney disease. In conclusion, the organization of post-transplant care needs to be adapted to the multi-morbidity of contemporary RTR and include multi-specialist care, especially in the context of current problems related to the COVID-19pandemic. The high proportion of patients with undetermined etiology of their primary renal disease carry the risk for additional complications during their long-term follow-up.

Keywords: comorbidities; follow-up; kidney transplantation; organization; outcome (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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