دورية أكاديمية
The Predictors and Risk Factors of 2-Year Rejection in Renal Transplant Patients: A Multicenter Case-Control Study.
| العنوان: | The Predictors and Risk Factors of 2-Year Rejection in Renal Transplant Patients: A Multicenter Case-Control Study. |
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| المؤلفون: | Alsulami MM; Department of Pharmaceutical Care, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia., Al-Otaibi NE; Department of Pharmaceutical Practices, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia., Alshahrani WA; College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.; Saudi Critical Care Pharmacy Research (SCAPE) Platform, Riyadh, Saudi Arabia., Altheaby A; Solid Organ Transplant Centre, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia., Al Thiab KM; Department of Pharmaceutical Care, King Abdulaziz Medical City, Riyadh, Saudi Arabia.; King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia., Alnajjar LI; Department of Pharmacy Practice, College of Pharmacy, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia., Albekery MA; Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al Hofuf, Saudi Arabia., Almutairy RF; Department of Pharmaceutical Care, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia.; Department of Pharmaceutical Sciences, Fakeeh College for Medical Sciences, Jeddah, Saudi Arabia., Asiri MY; Department of Pharmaceutical Care, Prince Mansour Military Hospital, Taif, Saudi Arabia., AlMohareb SN; College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.; Department of Pharmaceutical Care, King Abdulaziz Medical City, Riyadh, Saudi Arabia.; King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia., Alsehli FA; College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.; King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.; Department of Pharmaceutical Care, King Abdulaziz Medical City (KAMC) - Ministry of National Guard Health Affairs (MNGHA), Riyadh, Saudi Arabia., Binthuwaini AT; College of Nursing, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia., Almagthali A; Department of Pharmaceutical Care, King Abdulaziz University Hospital, Jeddah, Saudi Arabia., Alwaily SS; College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia., Alzahrani AY; College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia., Alrohile F; College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia., Alqurashi AE; Department of Pharmaceutical Care, Dr. Abdulrahman Bakhsh Hospital, Jeddah, Saudi Arabia., Alshareef H; Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi Arabia., Almarhabi H; Department of Medicine, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia.; King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.; King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia., Alharbi A; Department of Pharmaceutical Care, King Abdulaziz Medical City, Jeddah, Saudi Arabia., Alrashidi H; College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia., Alamri RM; College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia., Alnahari FN; College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia., Mohsin B; Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia., Odah NO; Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia., Habhab WT; Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia., Alfi YA; Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia., Alhaidal HA; College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia., Alghwainm M; Department of Pharmaceutical Care, King Abdulaziz Medical City, Riyadh, Saudi Arabia., Al Sulaiman K; College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.; Saudi Critical Care Pharmacy Research (SCAPE) Platform, Riyadh, Saudi Arabia.; Department of Pharmaceutical Care, King Abdulaziz Medical City, Riyadh, Saudi Arabia.; King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.; Saudi Society for Multidisciplinary Research Development and Education (SCAPE Society), Riyadh, Saudi Arabia. |
| المصدر: | American journal of nephrology [Am J Nephrol] 2024; Vol. 55 (4), pp. 487-498. Date of Electronic Publication: 2024 Apr 26. |
| نوع المنشور: | Journal Article; Multicenter Study |
| اللغة: | English |
| بيانات الدورية: | Publisher: Karger Country of Publication: Switzerland NLM ID: 8109361 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1421-9670 (Electronic) Linking ISSN: 02508095 NLM ISO Abbreviation: Am J Nephrol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Basel ; New York : Karger, [1981- |
| مواضيع طبية MeSH: | Kidney Transplantation*/adverse effects , Graft Rejection*/immunology , Graft Rejection*/epidemiology, Humans ; Male ; Female ; Case-Control Studies ; Risk Factors ; Adult ; Middle Aged ; Saudi Arabia/epidemiology ; Kidney Failure, Chronic/surgery ; Time Factors |
| مستخلص: | Introduction: Kidney transplantation is a definitive treatment for end-stage renal disease. It is associated with improved life expectancy and quality of life. One of the most common complications following kidney transplantation is graft rejection. To our knowledge, no previous study has identified rejection risk factors in kidney transplant recipients in Saudi Arabia. Therefore, this study aimed to determine the specific risk factors of graft rejection. Methods: A multicenter case-control study was conducted at four transplant centers in Saudi Arabia. All adult patients who underwent a renal transplant between January 1, 2015 and December 31, 2021 were screened for eligibility. Included patients were categorized into two groups (cases and control) based on the occurrence of biopsy-proven rejection within 2 years. The primary outcome was to determine the risk factors for rejection within the 2 years of transplant. Exact matching was utilized using a 1:4 ratio based on patients' age, gender, and transplant year. Results: Out of 1,320 screened renal transplant recipients, 816 patients were included. The overall prevalence of 2-year rejection was 13.9%. In bivariate analysis, deceased donor status, the presence of donor-specific antibody (DSA), intraoperative hypotension, Pseudomonas aeruginosa, Candida, and any infection within 2 years were linked with an increased risk of 2-year rejection. However, in the logistic regression analysis, the presence of DSA was identified as a significant risk for 2-year rejection (adjusted OR: 2.68; 95% CI: 1.10, 6.49, p = 0.03). Furthermore, blood infection, infected with Pseudomonas aeruginosa or BK virus within 2 years of transplant, were associated with higher odds of 2-year rejection (adjusted OR: 3.10; 95% CI: 1.48, 6.48, p = 0.003, adjusted OR: 3.23; 95% CI: 0.87, 11.97, p = 0.08 and adjusted OR: 2.76; 95% CI: 0.89, 8.48, p = 0.07, respectively). Conclusion: Our findings emphasize the need for appropriate prevention and management of infections following kidney transplantation to avoid more serious problems, such as rejection, which could significantly raise the likelihood of allograft failure and probably death. Further studies with larger sample sizes are needed to investigate the impact of serum chloride levels prior to transplant and intraoperative hypotension on the risk of graft rejection and failure. (© 2024 S. Karger AG, Basel.) |
| فهرسة مساهمة: | Keywords: BK virus: donor-specific antibody; Chloride; Infection; Intraoperative hypotension; Kidney transplant; Prediction; Pseudomonas; Rejection; Risk factors |
| تواريخ الأحداث: | Date Created: 20240428 Date Completed: 20240807 Latest Revision: 20240828 |
| رمز التحديث: | 20240830 |
| DOI: | 10.1159/000538963 |
| PMID: | 38679014 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1421-9670 |
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| DOI: | 10.1159/000538963 |