Resultados da distribui??o de rins por compatibilidade HLA na sobrevida do enxerto proveniente de doador falecido

• Ano de defesa: 2013
• Autor(a) principal: Hermann, Karla Cusinato
• Orientador(a): Saitovitch, David
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Pontif?cia Universidade Cat?lica do Rio Grande do Sul
• Programa de Pós-Graduação: Programa de P?s-Gradua??o em Medicina e Ci?ncias da Sa?de
• Departamento: Faculdade de Medicina
• País: BR
• Palavras-chave em Português: MEDICINA; NEFROLOGIA; RINS - TRANSPLANTE
• Área do conhecimento CNPq: CNPQ::CIENCIAS DA SAUDE::MEDICINA
• Link de acesso: http://tede2.pucrs.br/tede2/handle/tede/1739

Background : Kidney transplantation is recognized as the best form of treatment for patients needing renal replacement therapy, significantly improving the quality of life of patients and reducing mortality rates. It is known that the HLA compatibility improves the outcome of transplantations. In Rio Grande do Sul until 2001 transplant based on HLA compatibility between donor and recipient, but the results of this policy change are not yet known in the researched. Objective : Knowing the results in the researched of kidney transplants from deceased donors performed with HLA compatibility distribution as well as the association of these findings with other risk factors for graft loss and patient death. Method : A historical cohort study in a single center, involving 315 patients transplanted with kidneys from deceased donors. We evaluated the results of transplants occurred from May 2001 to May 2011 through the curves and overall survival by HLA compatibility and graft patient in 5 years, as well as analyzed the risk factors for graft loss and patient death . For survival curves, we used the Kaplan-Meier method and comparisons between them were made with the log rank test. For univariate and multivariate analysis of risk factors associated with the outcomes we used the method of Cox Regression. Results : 5-year overall survival of the graft was 69.8% and the patient was 82.1%. In this study could not demonstrate that HLA compatibility was a risk factor for graft loss or patient death. In multivariate analysis only recipient age was associated with death (HR 1.033 / p = 0.023) and graft loss was related to vascular and endocrine complicactions (HR 2.388 / p = 0.001 and HR 0.283 / p = 0.014, respectively). Conclusion : The results showed a graft survival and patient satisfaction in five years is comparable to that observed internationally. To demonstrate that the HLA can be related to graft survival and patient will need a larger sample. Vascular and endocrine complications have shown association with graft survival and recipient age was related to patient survival.