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Kidney transplantation is an effective treatment option and, in many cases, the best option for patients with end-stage renal disease. However, it still faces significant challenges that need to be addressed to improve the quality of life and survival of transplant recipients. Therefore, follow-up programs for these renal patients are essential. Hence, the objective of this study was to evaluate the outcomes of a kidney transplant program in a clinic in the Colombian Caribbean Region between the years 2019 and 2022.
An analytical cohort study was conducted, with a summary review of the variables, reported in means and standard deviations or medians and interquartile ranges depending on the normality of the variable. On the other hand, categorical variables were described using absolute and relative frequencies. The Student's t-test or Wilcox test was used depending on the normality of the variable. The Kruskal-Wallis test was employed to evaluate the medians obtained by patients in the Glomerular Filtration Rate (GFR) across four measurements. To analyze categorical variables, the exact Fisher test or the Chi-square test was used. A Kaplan-Meier analysis was performed to estimate graft survival according to donor type. A p-value of <0.05 was considered statistically significant. The R-CRAN software version 4.3.2 was used for statistical analyses.
In this study, which included 164 patients from the kidney transplant program, it was observed that the majority of participants were male (62%). Hypertension was the most common comorbidity (77%), followed by type 2 diabetes (16%). Regarding primary kidney diseases, Nephroangiosclerosis (NAH) (20%) and Diabetic Nephropathy (DN) (16%) were the most frequent. Approximately half of the transplants were performed with cadaveric donors (49%) and living donors (51%). The prevalences of graft loss and mortality were 8.5% and 2.4%, respectively. In the gender analysis, it was found that men had a higher prevalence of type 2 diabetes, while women had more hypertension. However, there were no statistically significant differences in primary kidney disease, GFR, donor type, Anti-HLA antibodies, graft loss, or mortality (p>0.05). When comparing donor type, it was observed that patients with cadaveric donors had a lower GFR in the last measurement and a longer cold ischemia time. However, there were no statistically significant differences in comorbidities, primary kidney disease, Anti-HLA antibodies, number of HLA matches, graft loss, or mortality (p>0.05). In the Kaplan-Meier analysis, the probability of 10-year graft survival was significantly higher in patients who received a transplant from a cadaveric donor compared to those who received a transplant from a living donor (89% vs. 60%), respectively. In this study, differences in GFR, cold ischemia time, and donor type were relevant findings for kidney transplant management.
The 10-year graft survival was notably higher in patients who received transplants from deceased donors, emphasizing the importance of this source of organs in the transplant program. This indicates that the management of kidney transplants in the Colombian Caribbean Region should be improved and optimized with the aim of benefiting a greater number of patients in the future.