Short term and Long term Survival Rate and Risk Factors of Graft Rejection after Deceased Donor Kidney Transplantation: A Systematic Review and Meta-Analysis

Introduction: The purpose of the current meta-analysis was to determine the short-term and long-term graft survival and patient survival from the deceased donors, and determine the prognostic factors.Methods: PubMed, Scopus, and Google Scholar databases were searched in March ۲۰۱۹ to obtain articles that report short-term and/or long-term graft and patient survival. The study also includes articles that analyzed the hazard ratio (HR) of graft rejection or patient death for deceased donor risk-related factors. The measures in this study could be summarized as the survival rate and the HR of graft rejection and patient death.Results: In the final analysis, ۷۵ articles were included. The ۱- and ۵-year graft survival were ۹۰% and ۷۶%, and for patient survival were ۹۵% and ۸۵% respectively. The ۱- and ۵-year graft survival in transplant donation after brain death (DBD) recipients were ۹۲% and ۷۹% and for patient survival were ۹۴% and ۹۰% respectively. The ۱- year graft and patient survival in donation after circulatory death (DCD) recipients were ۸۷% and ۹۵%, respectively. Also, the ۱- and ۵-year graft survival in patient expanded-criteria donors (ECDs) were ۸۸% and ۶۸%, and for patient survival were ۹۳% and ۸۷%, respectively. The ۱-year graft survival in standard-criteria donors (SCDs) recipients was ۹۳%, and ۱- and ۵-year patient survivals were ۹۶% and ۹۲%. Age of deceased donor, ECD kidney, and male sex were the significant prognostic factors for graft rejection.Conclusions: The findings of the first comprehensive meta-analysis of graft and patient survival of the deceased donor showed that the overall short-term and long-term graft and patient survival are desirable and confirm that ECD and DCD recipients have a poorer graft survival chance than standard donors.

Keywords:

Graft Survival , Patient Survival , Deceased Donor , systematic review and meta-Analysis