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Retrospective Study of Long-term Survival and Related Factors Among Kidney Transplant Recipients in China

Completed
Conditions
Kidney Transplantation
Registration Number
NCT01796639
Lead Sponsor
Novartis
Brief Summary

The primary objective of this study is to evaluate graft survival and recipient survival among kidney transplant recipients in China, and also to analyze possible factors related to patient and graft survival.

The secondary objective is to evaluate several secondary outcomes among kidney transplant recipients, such as average creatinine value, acute rejection episodes, NODM, incidence of BKV infection etc. At the same time analyze possible impact factors related to these secondary outcomes.

Detailed Description

Renal transplantation is the choice for patients with end-stage renal disease. In the past two decades, progress in surgical procedure, medical care, and immunosuppression have significantly improved the short-term results of organ transplantation. Nevertheless, grafts continue to fail over time, these improvements in immunosuppression and reduced incidence of acute rejection episodes have had only minimal effects on chronic allograft dysfunction and late graft loss. Long-term patient's death and graft failure are the main limitations for a better performance of renal transplant programs.

Multiple factors have been shown to affect the outcome of renal transplantation. These include demographic characteristics such as race and ethnicity, pretransplantation dialysis course, the timing of the transplantation,and the patients' co morbidities. Patient response to the transplantation procedure (e.g., delayed graft function, acute rejection, and acute tubular necrosis) is strongly associated with the long-term prognosis. In the last decade, with the increase of immunosuppressive agents in our therapeutic arsenal, several attempts have been made to improve graft performance. However, the majority of trials aiming to avoid calcineurin inhibitor (CNI)-related nephrotoxicity only reported short-term data. Also, and because of the lack of assessment of the role of the different ethiopathogenic factors that lead to graft damage, just avoiding CNI-related nephrotoxicity may be an oversimplification of the problem in the prevention of graft attrition.

There are many studies which have evaluated the long-term outcomes of graft and patient survival and have analyzed multiple relative factors. Unfortunately, such data in Chinese population are lacking. Meanwhile, the situation in China is somewhat different with others, such as race, the dosage of immunosuppressant and so on. A better characterization of the weight of immune and non-immune factors responsible for graft damage may help us to improve the outcomes in transplant recipients. Studies derived from well-designed and well-performed patient registries can provide a real world view of clinical practice, patient outcomes, safety, and comparative effectiveness and cost effectiveness. The goal of this project is to analyze retrospective data collected by disease registry, then to evaluate the graft and recipient outcomes of kidney transplants and relative impact factors.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
1500
Inclusion Criteria
  • Kidney transplant recipients
  • Received a transplant from Jan 1,1995 to Dec 31, 2007, only including those with living donor grafts
  • Age: 18-75 years
Exclusion Criteria
  • Multiple-organ transplant recipients
  • Patients records with missing information in 12 months post-transplantation
  • Patients who did not have the information regarding their maintenance immunosuppressive therapy

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Graft survival5-year

Graft survival, measured as the time between kidney transplant and the failure of the graft.

Recipient survival5-year

measured as the time between the most recent kidney transplant and the patient's death. Graft outcome was censored at the earliest of the following events and was analyzed as days to graft failure or censor: loss to follow-up, patient death.

Secondary Outcome Measures
NameTimeMethod
Average creatinine value5 years
The incidence of biopsy proven CNIs nephrotoxicity5 years
The rate of posttransplantation malignancies5 years
The incidence of NODM5 years
The incidence of infection5 years
The rate of acute rejection episodes5 years
The incidence of BPAR and its severity5 years

Trial Locations

Locations (18)

The First Affiliated Hospital of Zhengzhou University

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Zhengzhou, Henan, China

Nanfang Hospital

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Guangzhou, Guangdong, China

The Second Xiangya Hospital of Central South University

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Changsha, Hunan, China

West China Hospital,Sichuan University

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Chengdu, Sichuan, China

The First Affiliated Hospital, Zhejiang University

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Hangzhou, Zhejiang, China

Zhongshan Hospital Fudan University

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Shanghai, Shanghai, China

Chinese PLA General Hospital

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Beijing, Beijing, China

The First affiliated Hospital Sun Yat-sen University

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Guangzhou, Guangdong, China

Fuzhou General Hospital of Nanjing Military Command

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Fuzhou, Fujian, China

Tongji Hospital

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Wuhan, Hubei, China

The 309th Hospital of Chinese People's Liberation Army

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Beijing, Beijing, China

Beijing Chaoyang Hospital

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Beijing, Beijing, China

Beijing Friendship Hospital

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Beijing, Beijing, China

Shenyang Military General Hospital

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Shenyang, Liaoning, China

Jinan Military General Hospital

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Jinan, Shandong, China

Shanghai First People's Hospital

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Shanghai, Shanghai, China

First Affiliated Hospital of Medical College of Xian Jiaotong University

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Xian, Shanxi, China

Peking University First Hospital

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Beijing, Beijing, China

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