부산대학교 도서관

Purpose: We aimed to investigate the role of the recipient's age strata in modifying the associations between risk factors and mortality in non-elderly adult kidney transplant (KT) recipients (KTR).Methods: We stratified 108,695 adult KTRs between 2000 and 2016 with conditional 1-year survival after KT into cohorts based on age at transplant: 18–49 years and 50–64 years. We excluded KTRs aged < 18 years or > / = 65 years. KTRs were observed for 5 years during the 2nd through 6th years post-KT for the outcome, all-cause mortality.Results: Increasing recipient age strata (18–49-year-old and 50–64-year-old) correlated with decreasing 6-year post-KT survival rates conditional on 1-year survival (79% and 57%, respectively, p < 0.0001). Middle adult age stratum was associated with a higher risk of all-cause mortality than young adult age stratum in KTRs of Hispanic/Latino and other races [HR = 1.23, 95% CI = 1.04–1.45 and HR = 1.51, 95% CI = 1.16–1.97, respectively] and with a primary native renal diagnosis of hypertension or glomerulonephritis [HR = 1.32, 95% CI = 1.12–1.55 and HR = 1.29, 95% CI = 1.10–151, respectively]. When compared with the young adult age stratum, the middle adult age stratum had a mitigating effect on the higher risk of mortality associated with sirolimus-mycophenolate or sirolimus-tacrolimus than the standard calcineurin inhibitor-mycophenolate regimen [HR = 0.75, 95% CI = 0.57–0.99 and HR = 0.71, 95% CI = 0.57–0.89, respectively].Conclusion: Among adult non-elderly KTRs, the age strata, 18–49 years, and 50–64 years, have varying modifying effects on the strength and direction of associations between some specific risk factors and all-cause mortality.