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E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
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Introduction: Chronic kidney disease (CKD) impairs quality of life and imposes a substantial burden on healthcare systems. Kidney transplantation (KT) is the most effective treatment for patients with advanced CKD. In 2018, in Colombia, the Instituto Nacional de Salud (INS) established allocation criteria to optimize KT outcomes; however, their impact on patient survival has not been evaluated at either the national or local level.
Objectives: To identify the factors associated with patient survival after deceased donor kidney transplantation (DDKT) in a Colombian referral center.
Methods: Observational, retrospective cohort study based on the analysis of the database of DDKT recipients from the Fundación Oftalmológica de Santander (FOSCAL) between June 2012 and December 2023. Follow-up was performed until December 31, 2024, or until patient death. Patient survival and its associated factors were analyzed using Kaplan–Meier estimates and Cox regression, with statistical significance set at p < 0.05.
Results: A total of 263 DDKT recipients were included, divided into two groups: those transplanted before 2018 criteria and those under the 2018 INS allocation criteria. The median age was 53 years (range 18–78), and 69.2% were male. Hypertension was the most prevalent comorbidity (90.5%), followed by diabetes mellitus (DM) (28.9%); 5.7% of patients underwent a second transplant.
The leading cause of death was infection (47.4%), followed by unknown causes in an equal proportion, p = 0.119 (Table 1).
Patient survival at 1 and 5 years was 95.4% (95% CI: 92.0–97.4) and 81.2% (95% CI: 75.5–85.8), respectively. No statistically significant differences were found according to allocation criteria (HR: 1.33; p = 0.386).
In bivariate analysis, older recipient age was associated with higher mortality risk (HR 1.64; p < 0.001) (Figure 1), as was a history of DM (HR 2.65; p = 0.001) (Figure 2). Recipients without age-matched compatibility (donor <30 years/recipient <60 years or donor >60 years/recipient >60 years) had lower 5-year survival compared with the younger group, HR 6.2; p = 0.013 (Figure 3). Each additional HLA-B mismatch increased mortality risk, HR 2.23; p = 0.019 (Figure 4). Conversely, the absence of cardiovascular disease (CVD) was associated with a reduced mortality risk, HR 0.37; p = 0.013 (Figure 5). Blood group compatibility, total number of mismatches, and waiting time were not associated with patient survival (Table 2 and Table 3).
Conclusions: Patient survival after DDKT in this cohort reflects favorable clinical outcomes. The allocation criteria for kidney transplantation in Colombia did not impact 5-year patient survival. Based on our findings, advanced recipient age, donor–recipient age mismatch, DM, CVD, and HLA-B mismatch emerge as clinical factors compromising patient survival. A greater donor–recipient age disparity further accentuates this risk. These findings highlight the importance of recipient age, age-matching strategies, and immunological compatibility in improving post-transplant survival.
