The importance of analyzing graft and patient survival by cause of failure: an example using pediatric small intestine transplant data

Transplantation
Jeffrey J GaynorAndreas Tzakis

Abstract

Although graft and patient survival are vital in reporting overall results of clinical transplant studies, these outcomes do not account for distinct types of graft failure and death, which clearly exist in pediatric small intestine transplantation (Itx). The use of a cause-specific hazard (CSH) approach may provide more precise identification and thus greater insight as to why certain factors are prognostically important. Among 119 pediatric patients who received primary Itx at our center since 1994, Cox model stepwise regression analyses were performed to identify prognostic factors for the following CSH rates: intestinal graft failure (IGF)/death due to rejection, death due to infection not triggered by IGF, and intestinal graft loss/death due to other causes. Two factors were associated with a significantly higher rate of developing IGF due to rejection (23 such failures): receiving an isolated intestine or liver-intestine transplant (P=0.00001) and receiving no induction agent (P=0.006). Conversely, age at transplant <1 year was the single factor associated with a significantly higher death rate due to infection (P=0.0005) (21 such deaths). Two characteristics were associated with a significantly higher death rate due to o...Continue Reading

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Citations

Sep 26, 2007·Transplantation·Ian SchreibmanArie Regev
Aug 2, 2007·Annals of Surgery·Debra SudanAlan Langnas
Mar 16, 2007·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·G SelvaggiA G Tzakis
Feb 27, 2010·Clinical Transplantation·Dae Y KimAndreas G Tzakis
Jul 23, 2008·Transplantation·Tomoaki KatoAndreas Tzakis

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