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Changing Pattern of Mortality in Renal Transplant Recipients: A Single-Center, 30-Year Experience

Authors
  • Shu, K.-H.
  • Ho, H.-C.
  • Wen, M.-C.
  • Wu, M.-J.
  • Chen, C.-H.
  • Cheng, C.-H.
  • Yu, T.-M.
  • Chuang, Y.-W.
  • Huang, S.-T.
  • Tsai, S.-F.
  • Lo, Y.-C.
  • Weng, S.-C.1, 2, 3, 4, 5, 3, 6, 3, 7, 8, 9, 10
  • 1 Division of Nephrology
  • 2 Department of Internal Medicine
  • 3 Taichung Veterans General Hospital
  • 4 Division of Urology
  • 5 Department of Surgery
  • 6 Department of Pathology
  • 7 Institute of Medicine
  • 8 the Chung-Shan Medical University
  • 9 School of Medicine
  • 10 China Medical University
Type
Published Article
Journal
Transplantation Proceedings
Publisher
Elsevier
Publication Date
Jan 01, 2014
Volume
46
Issue
2
Pages
442–444
Identifiers
DOI: 10.1016/j.transproceed.2013.11.032
Source
Elsevier
License
Unknown

Abstract

IntroductionPatient survival among kidney transplant (KTx) recipients has improved remarkably in the past decades. The most common causes of death are cardiovascular disease in the West; in Taiwan, the answer remains uncertain. MethodsFrom 1983 to 2012, KTx patients who underwent transplantation and were followed at our hospital were recruited for the study. For comparison, patients were stratified according to the transplant time as group 1, 1983–1989 (the initial era); group 2, 1990–1998 (the cyclosporine era); and group 3, 1999–2012 (the modern era, in which tacrolimus and mycophenolate mofetil were available). ResultsA total of 520 KTx patients (male:female ratio of 285:235) were performed in our hospital during the study period. A progressive improvement in patient survival rates (P < .0001) was noted among the 3 groups. At a mean follow-up duration of 9.55 ± 8.20 years, 83 recipients had died. Overall, the most common cause of death was infection (44.6%), followed by cardiovascular disease (21.7%), malignancy (12.0%), and hepatic failure (10.8%). Infection was the main cause of death in groups 1 and 2 (44.1% and 52.6%, respectively) but not in Group 3 (18.2%), although this trend did not reach statistical significance. Death owing to cardiovascular diseases became the most common cause of death (27.3%) in the modern era (group 3). ConclusionThe pattern of mortality among Taiwanese KTx patients has changed over the past 30 years. Infection is no longer the commonest cause of death.

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