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Impact of timing of rejection episode on cardiovascular events in living donor kidney transplantation: a multicenter retrospective study
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Impact of timing of rejection episode on cardiovascular events in living donor kidney transplantation: a multicenter retrospective study
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Impact of timing of rejection episode on cardiovascular events in living donor kidney transplantation: a multicenter retrospective study
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Journal Article
Impact of timing of rejection episode on cardiovascular events in living donor kidney transplantation: a multicenter retrospective study
2023
Overview
Background
Cardiovascular diseases are still highly prevalent after kidney transplantation. However, little is known about the impact of the timing of rejection episodes on cardiovascular disease. The study aimed to analyze the influence of the timing of rejection episodes on cardiovascular events in recipients of living donor kidney transplantation.
Methods
We studied 572 living donor kidney transplant recipients from the Michinoku Renal Transplant Network (MRTN), which includes 6 centers in the Tohoku region of Japan. Fine-Gray proportional hazards regression analysis with time-dependent variables was used to assess the effect of rejection episode on cardiovascular events. Recipients were divided into three groups: those without rejection (non-rejection, 370 patients), rejection within 6 months after transplantation (early rejection, 99 patients), and rejection after 6 months (late rejection, 103 patients). The effect of timing on cardiovascular events was evaluated using Fine-Gray proportional hazards regression analysis.
Results
During a median follow-up of 77 months, 70 patients experienced cardiovascular events. Rejection episodes were significantly associated with cardiovascular events (hazard ratio [HR]: 2.08, 95% confidence interval [CI]: 1.26–3.43,
P
= 0.004), along with age and dialysis vintage. The 5-year cumulative incidence of cardiovascular events was significantly higher in the late rejection group than in the early rejection group (15% vs. 3.3%,
P
= 0.021). However, no significant difference in 5-year cumulative cardiovascular event incidence was observed between the early rejection and non-rejection groups. Late rejection was significantly associated with cardiovascular events (HR: 2.40, 95% CI: 1.38–4.18,
P
= 0.002), whereas early rejection was not significantly correlated with cardiovascular event risk (HR: 1.18,
P
= 0.670).
Conclusions
Rejections occurring more than 6 months after transplantation is significantly associated with risk of cardiovascular events.
Trial registration number
2019-099-1, date of registration; 3 Dec. 2019, retrospectively registered.
Graphical Abstract
Publisher
Springer Science and Business Media LLC,Springer International Publishing,Oxford University Press
Subject
/ Biopsy
/ Cardiovascular Diseases - diagnosis
/ Cardiovascular Diseases - epidemiology
/ Cardiovascular Diseases - etiology
/ Diabetes
/ Graft Rejection - epidemiology
/ Heart
/ Humans
/ Kidney Transplantation - adverse effects
/ Medicine
/ Patients
/ Renal Dialysis - adverse effects
/ Steroids
/ Urology
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