Multi-state survival analysis in renal transplantation recipients.

Iranian Journal of Public Health

Abbas Rahimi Foroushani¹  Kazem Mohammad¹  Mahmood Mahmoodi¹  Moghaddameh Mirzaee¹  Hojjat Zeraati¹  Mohammad Hasan Dehghani Firouzabadi²  Hossein Sattary²  Abbas Etminan²  Mohammad-Reza Ebadzadeh²  Mahdiyeh Haghparast²  Faramarz Fazeli³ 

[1] 1. Dept. of Epidemiology and Biostatistics, Tehran University of Medical Sciences , Tehran, Iran.;2. Physiology Research Center, Departments of Nephrology, Urology and Renal Transplantation, Kerman University of Medical Sciences , Kerman, Iran.;3. Dept. of Urology, Zahedan University of Medical Sciences , Zahedan, Iran.;

关键词: Death hazard;    Intermediate event;    Multi-state model;    Renal transplantation;   

DOI  :  

来源: DOAJ

【 摘 要 】

Renal transplantation is a therapy for end-stage renal disease. During the study of recipients' survival after renal transplantation, there are some events as intermediate events that not only affect the recipients' survival but also events which are affected by various factors. The aim of this study was to handle these intermediate events in order to identify factors that affect recipients' survival by using multi-state models.This retrospective cohort study included 405 renal transplant patients from Afzalipour Hospital, Kerman, Iran, from 2004 to 2010. The survival time of these recipients was determined after transplantation and the effect of various factors on the death hazard with and without renal allograft failure and hazard of renal allograft failure was studied by using multi-state models.During 4.06 years (median) of follow-up; 28 (6.9%) recipients died and allograft failure occurred in 51 (12.6%) recipients. Based on the results of multi-state model, receiving a living kidney transplantation decreased the hazard of renal allograft failure (HR=0.38; 95% CI: 0.17- 0.87), pre-transplant hypertension (HR=2.94; 95% CI: 1.54- 5.63) and serum creatinine levels >1.6 upon discharge from the hospital (HR=7.38; 95% CI: 3.87- 7.08) increased the hazard of renal allograft failure. Receiving living kidney transplantation decreased the hazard of death directly (HR=0.18; 95% CI: 0.04- 0.93).It was concluded that the effect of donor type, pre-transplant hypertension and having serum creatinine >1.6 upon discharge from the hospital was significant on hazard of renal allograft failure. The only variable that had a direct significant effect on hazard of death was donor type.

【 授权许可】

Unknown