Mediation analysis identifies causal factors that lead to increased rates of kidney transplant failure in patients with peripheral vascular disease - 10/02/25
Abstract |
Background |
This study aims to identify causal mediators of one-year kidney transplant failure in patients with peripheral vascular disease.
Methods |
Standard Transplant Analysis and Research database was queried for adults who underwent kidney transplantation from 1987 to 2021. Multi-organ transplant, prior transplant, and living donor kidneys were excluded. Causal mediation analysis with 2000 percentile bootstrapping interactions identified mediators of one-year kidney transplant failure.
Results |
212,259 patients were included: 16,215 with and 196,044 without peripheral vascular disease. Causal mediators of one-year kidney transplant failure are Kidney Donor Profile Index (proportionate mediation [PM] 17 %, p < 0.01, E-value = 1.20), pre-transplant dialysis (PM 19 %, p < 0.001, E-value = 1.17), recipient total serum albumin (PM 2 %, p = 0.003, E-value = 1.05), and donor hypertension (PM 1 %, p = 0.017, E-value = 1.04).
Conclusions |
Several causal mediators increase rates of one-year kidney transplant failure in patients with peripheral vascular disease. Understanding these mediators can improve pre-transplant assessments and post-transplant outcomes.
Il testo completo di questo articolo è disponibile in PDF.Highlights |
• | PVD is a known significant risk factor for kidney transplant graft failure. |
• | Pre-transplant dialysis and high KDPI mediate this increased graft failure risk. |
• | Mediation findings aid in better patient care and organ allocation strategies. |
Keywords : Peripheral vascular disease, Kidney transplant failure, Mediation analysis
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Vol 241
Articolo 116190- marzo 2025 Ritorno al numero
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