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Abstract: TH-PO164

Association of Post-Transplant Calcium and Phosphate Levels with Graft Outcomes

Session Information

Category: Transplantation

  • 1802 Transplantation: Clinical

Authors

  • Chevarria, Julio L., Beaumont Hospital, Dublin, Ireland
  • Sexton, Donal J., The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin., Dublin, Ireland
  • Ebad, Chaudhry Adeel, Beaumont Hospital, Dublin, Ireland
  • Kennedy, Claire, Beaumont Hospital, Dublin, Ireland
  • Murray, Susan Louise, Beaumont Hospital, Dublin, Ireland
  • Conlon, Peter J., Beaumont Hospital, Dublin 9, Co Dublin, Ireland
Background

Alterations in Ca and P are observed with varying impact on post-transplant outcomes and its implications in graft function are unclear. Our study assesses the relation between serum P and Ca during the first year and graft outcomes

Methods

Longitudinal single centre cohort study, we analyse 1524 first transplants, since 1991 to 2016. Our data was prospectively collected in the national kidney transplant registry. The primary outcome was graft failure and association with P and Ca on first year. We include patients >18 years and immunosuppression MMF + CNI + steroids. We categorized the P and Ca as low, normal or high. The analysis include Kaplan Meier and cox regression

Results

The age was 47.9 y (SD13.9), donor age 43.2 (SD13.3), 64.4% male, 59% HD, 29.5% PD, and 10.1% pre emptied, HLA mean 3.35 (SD1.5), time to fail 8.2 y (SD5.0), 297 grafts failed (18.4%), 85.1% has P<0.7 mmol/L the first year 0.52 (SD0.15), reached at 26.9 (SD46) days, 35.9% Ca >2.6 mmol/L, reached at 74.7 (85.9) days. The KM analysis show increase graft failure with low P or Ca pre transplant (p:0.03), better outcomes with low P at 1, 6 and 12 m (p:0.014, 0.04, 0.004), and high Ca at 1 month, but not so at 6 and 12 m (p:0.03, 0.7 and 0.6). Cox regression show HR 0.60; 95% CI 0.29 to 1.26 with low P and HR 0.71; 95% CI 0.52 to 0.98 with high Ca for graft failure

Conclusion

The derangements in Ca and P are frequent post transplant and develop the first months. The post transplant hypercalcemia is associated with better graft outcomes however the hypophosphatemia not. Futures trials will investigate if the treatment of these conditions would be a risk factor in these patients

Cox regresion model for High Calcium at 1st month
VariablesSig.Exp (B)95% CI LL95% CI UL
Minimum P (mmol/L)0.040.710.520.98
Rejection0.011.931.332.81
Age (Years)0.011.041.031.05
DGF (days)0.011.041.021.07