Abstract: TH-PO978

Causes of Death among Kidney Transplant Recipients in the United States

Session Information

Category: Transplantation

  • 1702 Transplantation: Clinical and Translational

Authors

  • Navaneethan, Sankar D., Baylor College of Medicine, Houston, Texas, United States
  • Niu, Jingbo, Baylor College of Medicine, Houston, Texas, United States
  • Mandayam, Sreedhar A., None, Bellaire, Texas, United States
  • Shawar, Saed, Baylor College of Medicine, Houston, Texas, United States
  • Pan, Jenny S., Baylor College of Medicine, Houston, Texas, United States
  • Erickson, Kevin F., Baylor College of Medicine, Houston, Texas, United States
  • Winkelmayer, Wolfgang C., Baylor College of Medicine, Houston, Texas, United States
  • Ramanathan, Venkat, Baylor College of Medicine, Houston, Texas, United States
Background


Mortality rate among kidney transplant recipients is lower than the dialysis population. However, except for single center studies, comprehensive examination of reasons for death among those with functioning allograft is lacking. Herein, we studied the causes of death among those who underwent kidney transplantation in the United States.

Methods


We examined United States Renal Data System (USRDS) database to identify patients (age >18 years) who received their first kidney transplantation between 1996 and 2012, and subsequently died with functioning graft. Deaths were classified into: a) cardiovascular, b) infectious, c) malignancy, d) others and e) unknown reasons. We examined the trends for 1-year and 10-year risk of death due to above mentioned causes for the study population.We also used competing risk models to assess the associations between transplantation year and each cause-specific mortality during 10-year follow-up.

Results


We included 196,748 transplant recipients and among them, 40,742 died with functioning allograft. Of these, cause of death was reported as unknown for 64% of patients. For those with reported cause of death, cardiovascular deaths accounted for 37%, malignancy: 14%, infection: 21% and other causes: 28% of deaths. One and 10-year trends for these various causes of deaths are shown in Figure 1. Patients who underwent transplantation in later years had lower hazards of death (for various causes) compared to patients who underwent transplantation in 1996 (Figure 2).

Conclusion

In this national registry of kidney transplant population, cause of death is unknown for substantial proportion of patients dying with functioning allografts. Risk for deaths due to cardiovascular disease and other causes have decreased over time.