Retrospective Study of Long-term Survival and Related Factors Among Kidney Transplant Recipients in China
Condition: Kidney Transplantation
Study type: Observational

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.
    

Observational model: Cohort
Time perspective: Retrospective
Sampling method: Probability Sample
Study population: 
        male and female kidney transplantation patients with living-donor grafts, > 18 years of age