USF-LVHN SELECT
Mediation analysis identifies causal factors that lead to increased rates of kidney transplant failure in patients with peripheral vascular disease.
Publication/Presentation Date
1-7-2025
Abstract
BACKGROUND: This study aims to identify causal mediators of one-year kidney transplant failure in patients with peripheral vascular disease.
METHODS: Standard Transplant Analysis and Research database was queried for adults who underwent kidney transplantation from 1987 to 2021. Multi-organ transplant, prior transplant, and living donor kidneys were excluded. Causal mediation analysis with 2000 percentile bootstrapping interactions identified mediators of one-year kidney transplant failure.
RESULTS: 212,259 patients were included: 16,215 with and 196,044 without peripheral vascular disease. Causal mediators of one-year kidney transplant failure are Kidney Donor Profile Index (proportionate mediation [PM] 17 %, p < 0.01, E-value = 1.20), pre-transplant dialysis (PM 19 %, p < 0.001, E-value = 1.17), recipient total serum albumin (PM 2 %, p = 0.003, E-value = 1.05), and donor hypertension (PM 1 %, p = 0.017, E-value = 1.04).
CONCLUSIONS: Several causal mediators increase rates of one-year kidney transplant failure in patients with peripheral vascular disease. Understanding these mediators can improve pre-transplant assessments and post-transplant outcomes.
Volume
241
First Page
116190
Last Page
116190
ISSN
1879-1883
Published In/Presented At
Torikashvili, J., Kendall, M. A., Zander, T., Parikh, R., Kuo, P. C., & Grimsley, E. A. (2025). Mediation analysis identifies causal factors that lead to increased rates of kidney transplant failure in patients with peripheral vascular disease. American journal of surgery, 241, 116190. Advance online publication. https://doi.org/10.1016/j.amjsurg.2025.116190
Disciplines
Medical Education | Medicine and Health Sciences
PubMedID
39809110
Department(s)
USF-LVHN SELECT Program, USF-LVHN SELECT Program Students
Document Type
Article
