Diagnostic predictors of complications and survival after renal transplantation in cats

Objective-To identify preoperative diagnostic results that predict postoper ative complications and survival in feline renal-transplant recipients. Study Design-Retrospective clinical study. Animals-Sixty-one feline renal allograft recipients. Methods-Medical records for 61 consecutive cats that underwent renal allogr aft transplantation between January 1, 1996, and December 1, 1999, were rev iewed. Age, diagnosis, body weight, body condition score, preoperative medi cal treatment, systolic blood pressure, packed cell volume, biochemical par ameters at admission and at the time of surgery, postoperative complication s, and postoperative survival were recorded. Associations of preoperative d ata with the occurrence of postoperative complications were determined usin g logistic regression. Postoperative survival was graphed using a Kaplan-Me ier cumulative-survival plot. Associations of covariates with postoperative survival were analyzed using Cox proportional hazards analysis. Results-Two parameters were significantly associated with occurrence of pos toperative central nervous system (CNS) disorders: blood urea nitrogen conc entration (odds ratio 1.083; 95% CI = 1.018 to 1.148) and serum creatinine concentration (odds ratio = 1.8; 95% CI 1.413 to 2.187) at the time of surg ery. Postoperative survival 6 months after transplantation was 59%, though 3-year survival remained at 42%. Of all covariates investigated, only recip ient age (relative hazard = 1.183; 95% CI = 1.039 to 1.334) was significant ly associated with survival. Conclusion and Clinical Relevance-Standard measures of preoperative renal d ysfunction do not predict postoperative survival in cats after renal transp lantation, although an increase in the degree of preoperative azotemia is a ssociated with an increased risk of CNS disorders after surgery. Increased recipient age is associated with decreased survival after renal transplanta tion. (C) Copyright 2001 by The American College of Veterinary Surgeons.