Causes of death after kidney transplantation

Abstract

During the 5-yr period (Sept. 1974-Aug. 1979), 209 consecutive patients received their 1st kidney transplant in Denver [Colorado, USA]. During 2.5-7.5 yr of follow-up, 54 patients (26%) died. Infection was the leading cause of death during all intervals and was responsible for 22 (41%) of the 54 deaths. Pneumonia was primarily responsible for 14 of the 22 deaths from infection. The other causes of death were cardiovascular problems in 11 patients (20%), suicide in 8 patients (15%), gastrointestinal (GI) tract problems in 7 patients (13%), malignant neoplasam in 2 patients (4%), and miscellaneous problems in 4 patients (7%). Of the 54 deaths 26 (48%) occurred more than 1 yr after primary transplantation; 12 of these 26 patients had already returned to chronic hemodialysis. To minimize mortality after transplantation, patients and their physicians must remain alert to the ongoing risks to which these patients are exposed, including the risks of sudden death from infection, myocardial infarction, pulmonary embolus, suicide or GI tract perforation.