Abstract: PUB344
Graft Nephrectomy Rates in Australia and New Zealand, 2001-2015
Session Information
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Pan, Chen, Kidney Health Service, Royal Brisbane and Women’s Hospital, Brisbane, Queensland, Australia
- Johnson, David W., Metro South Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia
- Hawley, Carmel, Metro South Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia
- Pascoe, Elaine, Centre for Health Services Research, University of Queensland, Brisbane, Queensland, Australia
- McDonald, Stephen P., Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Boudville, Neil, Medical School, University of Western Australia, Perth, Western Australia, Australia
- Jose, Matthew D., Department of Nephrology, Royal Hobart Hospital, Hobart, Tasmania, Australia
- Cross, Nicholas, Department of Nephrology, Te Whatu Ora Waitaha Canterbury, Christchurch, Canterbury, New Zealand
- Fahim, Magid, Metro South Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia
- Palamuthusingam, Dharmenaan, Kidney Health Service, Royal Brisbane and Women’s Hospital, Brisbane, Queensland, Australia
- Ng, Monica Suet Ying, Kidney Health Service, Royal Brisbane and Women’s Hospital, Brisbane, Queensland, Australia
Background
Over the past two decades there has been increasing evidence associating graft nephrectomy with risks of sensitisation — challenging earlier paradigms that graft nephrectomy was an important component of care after graft failure. It is unclear how this evidence has altered contemporary graft nephrectomy rates and cohorts in Australia and New Zealand.
Methods
Probabilistic data linkage between Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry and statewide hospital admission datasets were used to evaluate graft nephrectomy rates and demographics of people undergoing graft nephrectomies between 2001 and 2015. Year of graft nephrectomy was categorised as 2001-2005, 2006-2010 and 2011-2015. Demographic features such as age at graft nephrectomy, sex, primary kidney disease, ethnicity, cardiovascular disease, chronic lung disease, diabetes, smoking status, body mass index, human lymphocyte antigen mismatch, panel reactive antibodies, dialysis vintage, graft failure cause, kidney transplant year and graft number. Clinical outcome measures such as mortality and transplant after nephrectomy were also assessed. To evaluate change in demographic features over time, continuous variables were assessed using one-way ANOVA and categorical variables were assessed using Fisher exact test.
Results
Between 2001-2015, there were 15,019 transplant recipients with grafts in situ and 1,038 graft nephrectomies. Forty-nine people had multiple graft nephrectomies. Graft nephrectomy rates remained consistent over this period from 9.67 per 1000 person years in 2001-2005, 10.3 per 1000 person years in 2006-2010 and 8.96 per 1000 person years in 2011-2015. Over this period, there were increases in HLA mismatches and dialysis vintage, along with reductions in ischaemia time. Age at graft nephrectomy, recipient sex, primary kidney disease, recipient race, comorbidities, smoking status, body mass index, and donor source remained similar across the observation periods.
Conclusion
Graft nephrectomy rates have not changed significantly across Australia and New Zealand between 2001 and 2015.