Causas de muerte en pacientes con un injerto renal funcionante: ¿Han ocurrido cambios en las últimas décadas?

Background: Death with a functioning graft (DWGF) is now one of the main causes of renal transplant (RTx) loss. Aim: To determine whether the causes of DWGF, characteristics of donors and recipients and complications of RTx have changed in the last two decades. Subjects and Methods: Cooperative stud...

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Autores principales:	Vega,Jorge, Videla,Christian, Borja,Hernán, Goecke,Helmuth, Martínez,Felipe, Betancour,Pablo
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2012
Materias:	Immunosuppressive agents Kidney transplantation Morbidity Mortality Prognosis Treatment outcome
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872012000300003
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spelling	oai:scielo:S0034-988720120003000032012-05-31Causas de muerte en pacientes con un injerto renal funcionante: ¿Han ocurrido cambios en las últimas décadas?Vega,JorgeVidela,ChristianBorja,HernánGoecke,HelmuthMartínez,FelipeBetancour,Pablo Immunosuppressive agents Kidney transplantation Morbidity Mortality Prognosis Treatment outcome Background: Death with a functioning graft (DWGF) is now one of the main causes of renal transplant (RTx) loss. Aim: To determine whether the causes of DWGF, characteristics of donors and recipients and complications of RTx have changed in the last two decades. Subjects and Methods: Cooperative study of a cohort of 418 kidney grafts performed between 1968 and 2010. Patients were divided into two groups according to whether their kidney transplants were performed between 1968 and 1992 (Group 1) or 1993 and 2010 (Group 2). Results: Sixty eight patients experienced DWGF. Infections were the leading cause of DWGF in both groups (38 and 41%, respectively), followed by cardiovascular diseases (24 and 23% respectively), gastrointestinal disorders (21 and 26% respectively) and cancer (17 and 10% respectively). There were no significant differences in causes of death between the two groups according to the time elapsed since the renal transplantation. In patients in Group 1, the interval between diagnosis of renal failure and dialysis (HD) and the interval between the start of HD and kidney transplantation were significantly lower than in Group 2. The former had also an increased number of acute rejections in the first five years of kidney transplantation (p < 0.001). In Group 2, patients more often received their kidneys from deceased donors, had previous kidney transplantation, higher rate of antibodies to a panel of lymphocytes and an increased incidence of cardiovascular disorders after five years of RTx. Conclusions: The proportion of graft loss due to DWGF has increased over the last 2 decades, but its causes have not changed significantly. Infections are the most common causes of DWGF followed by cardiovascular and digestive diseases.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.140 n.3 20122012-03-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872012000300003es10.4067/S0034-98872012000300003
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Immunosuppressive agents Kidney transplantation Morbidity Mortality Prognosis Treatment outcome
spellingShingle	Immunosuppressive agents Kidney transplantation Morbidity Mortality Prognosis Treatment outcome Vega,Jorge Videla,Christian Borja,Hernán Goecke,Helmuth Martínez,Felipe Betancour,Pablo Causas de muerte en pacientes con un injerto renal funcionante: ¿Han ocurrido cambios en las últimas décadas?
description	Background: Death with a functioning graft (DWGF) is now one of the main causes of renal transplant (RTx) loss. Aim: To determine whether the causes of DWGF, characteristics of donors and recipients and complications of RTx have changed in the last two decades. Subjects and Methods: Cooperative study of a cohort of 418 kidney grafts performed between 1968 and 2010. Patients were divided into two groups according to whether their kidney transplants were performed between 1968 and 1992 (Group 1) or 1993 and 2010 (Group 2). Results: Sixty eight patients experienced DWGF. Infections were the leading cause of DWGF in both groups (38 and 41%, respectively), followed by cardiovascular diseases (24 and 23% respectively), gastrointestinal disorders (21 and 26% respectively) and cancer (17 and 10% respectively). There were no significant differences in causes of death between the two groups according to the time elapsed since the renal transplantation. In patients in Group 1, the interval between diagnosis of renal failure and dialysis (HD) and the interval between the start of HD and kidney transplantation were significantly lower than in Group 2. The former had also an increased number of acute rejections in the first five years of kidney transplantation (p < 0.001). In Group 2, patients more often received their kidneys from deceased donors, had previous kidney transplantation, higher rate of antibodies to a panel of lymphocytes and an increased incidence of cardiovascular disorders after five years of RTx. Conclusions: The proportion of graft loss due to DWGF has increased over the last 2 decades, but its causes have not changed significantly. Infections are the most common causes of DWGF followed by cardiovascular and digestive diseases.
author	Vega,Jorge Videla,Christian Borja,Hernán Goecke,Helmuth Martínez,Felipe Betancour,Pablo
author_facet	Vega,Jorge Videla,Christian Borja,Hernán Goecke,Helmuth Martínez,Felipe Betancour,Pablo
author_sort	Vega,Jorge
title	Causas de muerte en pacientes con un injerto renal funcionante: ¿Han ocurrido cambios en las últimas décadas?
title_short	Causas de muerte en pacientes con un injerto renal funcionante: ¿Han ocurrido cambios en las últimas décadas?
title_full	Causas de muerte en pacientes con un injerto renal funcionante: ¿Han ocurrido cambios en las últimas décadas?
title_fullStr	Causas de muerte en pacientes con un injerto renal funcionante: ¿Han ocurrido cambios en las últimas décadas?
title_full_unstemmed	Causas de muerte en pacientes con un injerto renal funcionante: ¿Han ocurrido cambios en las últimas décadas?
title_sort	causas de muerte en pacientes con un injerto renal funcionante: ¿han ocurrido cambios en las últimas décadas?
publisher	Sociedad Médica de Santiago
publishDate	2012
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872012000300003
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Causas de muerte en pacientes con un injerto renal funcionante: ¿Han ocurrido cambios en las últimas décadas?

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