Organ Specificity of Chronic Graft Dysfunction: An Analysis Based on Data of OPTN_Chinese Journal of Evidence-Based Medicine

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Chronic graft dysfunction (CGD); Organ specificity; OPTN; SRTR; Graft survival; Solid organ transplantation

DOI：

10.7507/1672-2531.20080216

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Objective 　Chronic graft dysfunction (CGD) has become the major factor that influences the long-term survival of grafts. It is unclear whether the different incidence of CGD has organ specificity.
Methods 　We collected the graft survival rates (GSRs) of solid organ transplantations from the OPTN/SRTR (organ procurement and transplantation network/ scientific registry of transplant recipient). The solid organ transplantations were classified according to the cluster analyses of GSRs during two time periods. We defined the standard of lower survival rate and compared it to the 3-month GSRs (3mGSRs), 1-year GSRs (1y GSRs), 3y GSRs, and 5y GSRs of various solid organ transplantations.
Results 　Deceased donor ECD kidney (DD-ECDK), pancreas transplantation alone (PTA), pancreas after kidney transplantation (PAK), Intestine (In), deceased donor lung (DD-Lu), and heart-lung (H-Lu) were classified into a category which was associated with lower graft survival rates based on the variables of GSRs during the time periods of 1991-1995 and 1996-2000. Compared with those of DD-ECDK, the lowest in the three types of kidney transplantation, the GSRs during the two time periods of the above organ transplantations of lower graft survival were lower [3mGSRs: OR 0.26-0.92, 95%CI (0.20, 0.35)-(0.61,1.39); 1y GSRs : OR 0.30-0.87, 95%CI (0.23,0.37)-(0.78,0.97); 3y GSRs: OR 0.39-0.77, 95%CI (0.30,0.51)-(0.61,0.98); 5y GSRs: OR 0.12-0.87, 95%CI (0.09,0.71)- (0.75,1.0)].
Conclusion 　 The CGD had organ specificity. The grafts of DD-ECDK, PTA, PAK, In, DD-Lu, and H-Lu were identified as the organs with earlier onsets and higher incidence of CGD.

Citation： LI Youping,TANG Yong,LI Yongsheng,LI Lulu,DIAO Xiang,WEN Jin. Organ Specificity of Chronic Graft Dysfunction: An Analysis Based on Data of OPTN. Chinese Journal of Evidence-Based Medicine, 2008, 08(11): 972-979. doi: 10.7507/1672-2531.20080216 Copy

1.	Port FK, Merion RM, Goodrich NP, et al. Recent trends and results for organ donation and transplantation in the United States, 2005. Am J Transplant, 2006, 6(p2): 1095-1100.
2.	2006 OPTN/SRTR Annual Report 1994-2004. HHS/HRSA/SPB/DOT; UNOS; URREA. http://www.optn.org/.
3.	Cohen DJ, Martin LS, Christensen LL, et al. Kidney and pancreas transplantation in the United States, 1995-2004. Am J Transplant, 2006, 6(part 2): 1153-1169.
4.	Gruessner AC, Sutherland DER. Pancreas transplant outcomes for United States (US) and non-US cases as reported to the United Network for Organ Sharing (UNOS) and the International Pancreas Transplant Registry (IPTR) as of June 2004. Clin Transplant, 2005, 19: 433-455.
5.	Humar A, Khwaja K, Ramcharan T, et al. Chronic rejection: the next major challenge for pancreas transplant recipients. Transplantation, 2003, 76(6): 918-923.
6.	Boucek MM, Edwards LB, Keck BM, et al. Registry of the International Society for Heart and Lung Transplantation: Eighth Official Pediatric Report—2005. J Heart Lung Transplant, 2005, 24:968–982.
7.	Noronha IL, Oliverira SG, Tavares TS, et al. Apoptosis in kidney and pancreas allograft biopsies. Transplantation, 2005, 79(9):1231-1235.
8.	Ito T, Uchikoshi F, Tori M, et al. Immunological characteristics of pancreas transplantation: Review and our experimental experience. Pancreas, 2003, 27(1): 31-37.
9.	Newell KA. Transplantation of the intestine: is it truly different? Am J Transplant, 2003, 3: 1–2.
10.	Takahashi H, Selvaggi G, Nishida S, et al. Organ –specific differences in acute rejection intensity in a multivisceral transplantation. Transplantation, 2006, 81(2): 297-299.
11.	Tzakis AG, Kato T, Levi DM, et al. 100 multivisceral transplants at a single center. Ann Surg, 2005, 242(2): 480-493.

1. Port FK, Merion RM, Goodrich NP, et al. Recent trends and results for organ donation and transplantation in the United States, 2005. Am J Transplant, 2006, 6(p2): 1095-1100.
2. 2006 OPTN/SRTR Annual Report 1994-2004. HHS/HRSA/SPB/DOT; UNOS; URREA. http://www.optn.org/.
3. Cohen DJ, Martin LS, Christensen LL, et al. Kidney and pancreas transplantation in the United States, 1995-2004. Am J Transplant, 2006, 6(part 2): 1153-1169.
4. Gruessner AC, Sutherland DER. Pancreas transplant outcomes for United States (US) and non-US cases as reported to the United Network for Organ Sharing (UNOS) and the International Pancreas Transplant Registry (IPTR) as of June 2004. Clin Transplant, 2005, 19: 433-455.
5. Humar A, Khwaja K, Ramcharan T, et al. Chronic rejection: the next major challenge for pancreas transplant recipients. Transplantation, 2003, 76(6): 918-923.
6. Boucek MM, Edwards LB, Keck BM, et al. Registry of the International Society for Heart and Lung Transplantation: Eighth Official Pediatric Report—2005. J Heart Lung Transplant, 2005, 24:968–982.
7. Noronha IL, Oliverira SG, Tavares TS, et al. Apoptosis in kidney and pancreas allograft biopsies. Transplantation, 2005, 79(9):1231-1235.
8. Ito T, Uchikoshi F, Tori M, et al. Immunological characteristics of pancreas transplantation: Review and our experimental experience. Pancreas, 2003, 27(1): 31-37.
9. Newell KA. Transplantation of the intestine: is it truly different? Am J Transplant, 2003, 3: 1–2.
10. Takahashi H, Selvaggi G, Nishida S, et al. Organ –specific differences in acute rejection intensity in a multivisceral transplantation. Transplantation, 2006, 81(2): 297-299.
11. Tzakis AG, Kato T, Levi DM, et al. 100 multivisceral transplants at a single center. Ann Surg, 2005, 242(2): 480-493.

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Organ Specificity of Chronic Graft Dysfunction: An Analysis Based on Data of OPTN

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