Evolution of Causes of Mortality in Renal Transplantation in the Last 10 Years

Introduction: Improvements in immunosuppressive therapy have significantly changed results of organ transplantation. The aim of this study was to review the causes of mortality among our renal transplant population. Methods: This study population included 750 patients who underwent kidney transplantation between 1970 and 2007. During the follow-up, we recorded all causes of death and major cardiovascular events: stroke, myocardial infarction, angina pectoris, and cardiac death were considered major adverse cardiovascular events (MACE) The occurrence of MACE was related to wellestablished cardiovascular risk factors-age, sex, arterial blood pressure, diabetes, renal function, cardiovascular body mass index, history, or dyslipidemia measured at 6 months, as well as 5 and 10 years after transplantation. At these times we also calculated the INDANA, Framingham, and ltalian Heart Project scores. Results: The median follow-up was 63 months and mean age was 45 ± 11 years. The median waiting time for transplant was 34 months. During follow up, 22 patients (6.1%) developed MACE, with 2 (0.55%) events within 6 months 10 (3.1%) between 6 months and 5 years, and 10 (6.5%) between 5 and 10 years. The INDANA score at all the time periods was significantly different among patients with vs without MACE (P < .0001), whereas no significant difference was observed using the Framinghan or the Italian Heart Project scores (P < .11). Conclusion: Our study indicated that the INDANA scoring system better predicted the risk of MACE as approved to the Framinghan or Italian Heart Project systems. The INDANA score might be used to plan selective cardiovascular screening among recipients.