Trends in underlying causes of death in solid organ transplant recipients between 2010 and 2020: Using the CLASS method for determining specific causes of death
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Trends in underlying causes of death in solid organ transplant recipients between 2010 and 2020 : Using the CLASS method for determining specific causes of death. / Søborg, Andreas; Reekie, Joanne; Rasmussen, Allan; Cunha-Bang, Caspar Da; Gustafsson, Finn; Rossing, Kasper; Perch, Michael; Krohn, Paul Suno; Sørensen, Søren Schwartz; Lund, Thomas Kromann; Sørensen, Vibeke Rømming; Ekenberg, Christina; Lundgren, Louise; Lodding, Isabelle Paula; Moestrup, Kasper Sommerlund; Lundgren, Jens; Wareham, Neval Ete.
In: PLoS ONE, Vol. 17, No. 7 , e0263210, 2022.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Trends in underlying causes of death in solid organ transplant recipients between 2010 and 2020
T2 - Using the CLASS method for determining specific causes of death
AU - Søborg, Andreas
AU - Reekie, Joanne
AU - Rasmussen, Allan
AU - Cunha-Bang, Caspar Da
AU - Gustafsson, Finn
AU - Rossing, Kasper
AU - Perch, Michael
AU - Krohn, Paul Suno
AU - Sørensen, Søren Schwartz
AU - Lund, Thomas Kromann
AU - Sørensen, Vibeke Rømming
AU - Ekenberg, Christina
AU - Lundgren, Louise
AU - Lodding, Isabelle Paula
AU - Moestrup, Kasper Sommerlund
AU - Lundgren, Jens
AU - Wareham, Neval Ete
N1 - Publisher Copyright: Copyright: © 2022 Søborg et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2022
Y1 - 2022
N2 - Monitoring specific underlying causes of death in solid organ transplant (SOT) recipients is important in order to identify emerging trends and health challenges. This retrospective cohort study includes all SOT recipients transplanted at Rigshospitalet between January 1st, 2010 and December 31st, 2019. The underlying cause of death was determined using the newly developed Classification of Death Causes after Transplantation (CLASS) method. Cox regression analyses assessed risk factors for all-cause and cause-specific mortality. Of the 1774 SOT recipients included, 299 patients died during a total of 7511 person-years of follow-up (PYFU) with cancer (N = 57, 19%), graft rejection (N = 55, 18%) and infections (N = 52, 17%) being the most frequent causes of death. We observed a lower risk of all-cause death with increasing transplant calendar year (HR 0.91, 95% CI 0.86–0.96 per 1-year increase), alongside death from graft rejection (HR 0.84 per year, 95% CI 0.74–0.95) and death from infections (HR 0.86 per year, 95% CI 0.77–0.97). Further, there was a trend towards lower cumulative incidence of death from cardiovascular disease, graft failure and cancer in more recent years, while death from other organ specific and non-organ specific causes did not decrease. All-cause mortality among SOT recipients has decreased over the past decade, mainly due to a decrease in graft rejection- and infection-related deaths. Conversely, deaths from a broad range of other causes have remained unchanged, suggesting that cause of death among SOT recipients is increasingly diverse and warrants a multidisciplinary effort and attention in the future.
AB - Monitoring specific underlying causes of death in solid organ transplant (SOT) recipients is important in order to identify emerging trends and health challenges. This retrospective cohort study includes all SOT recipients transplanted at Rigshospitalet between January 1st, 2010 and December 31st, 2019. The underlying cause of death was determined using the newly developed Classification of Death Causes after Transplantation (CLASS) method. Cox regression analyses assessed risk factors for all-cause and cause-specific mortality. Of the 1774 SOT recipients included, 299 patients died during a total of 7511 person-years of follow-up (PYFU) with cancer (N = 57, 19%), graft rejection (N = 55, 18%) and infections (N = 52, 17%) being the most frequent causes of death. We observed a lower risk of all-cause death with increasing transplant calendar year (HR 0.91, 95% CI 0.86–0.96 per 1-year increase), alongside death from graft rejection (HR 0.84 per year, 95% CI 0.74–0.95) and death from infections (HR 0.86 per year, 95% CI 0.77–0.97). Further, there was a trend towards lower cumulative incidence of death from cardiovascular disease, graft failure and cancer in more recent years, while death from other organ specific and non-organ specific causes did not decrease. All-cause mortality among SOT recipients has decreased over the past decade, mainly due to a decrease in graft rejection- and infection-related deaths. Conversely, deaths from a broad range of other causes have remained unchanged, suggesting that cause of death among SOT recipients is increasingly diverse and warrants a multidisciplinary effort and attention in the future.
U2 - 10.1371/journal.pone.0263210
DO - 10.1371/journal.pone.0263210
M3 - Journal article
C2 - 35877606
AN - SCOPUS:85135282552
VL - 17
JO - PLoS ONE
JF - PLoS ONE
SN - 1932-6203
IS - 7
M1 - e0263210
ER -
ID: 329228658