Front Nephrol. 2026 May 26;6:1817080. doi: 10.3389/fneph.2026.1817080. eCollection 2026.
ABSTRACT
BACKGROUND: Kidney transplantation remains the most effective therapy for End-Stage Renal Disease. While global outcomes have improved, data from Latin America are limited.
OBJECTIVE: to describe the institutional experience of a national kidney transplant program in Colombia and to analyze patient and graft survival, acute rejection, and graft loss over time.
METHODS: The objective of this research was to describe the institutional experience of a national kidney transplant program in Colombia and to analyze patient, graft, and rejection-free survival across nearly two decades. A retrospective cohort study included all adults who underwent kidney transplantation at a national referral center in Colombia between April 2006 and 5 October 2025. Outcomes were overall, graft, and rejection-free survival, analyzed with Kaplan-Meier and competing-risk models, and compared across three transplant eras (2006-2011, 2012-2018, 2019-2025).
RESULTS: A total of 422 kidney transplant recipients were included (38.4% female, 61.6% male). Renal vascular disease was the leading cause of kidney failure (38.5%). Kaplan-Meier analyses showed no sex differences; 1-year patient survival was 92.1% (95% CI: 87.8-94.9) in males and 96.7% (95% CI: 92.3-98.6) in females (p = 0.082). Era-stratified analyses demonstrated significant improvement in 1-year graft survival (log-rank p = 0.015) and a trend toward higher rejection-free survival, reaching 93.8% (95% CI: 88.4-96.7) in 2019-2025 (p = 0.062). In competing-risk analysis, death was more frequent than graft failure; at 15 years, cumulative incidence was 42.2% for death versus 17.8% for graft failure.
CONCLUSION: Over 19 years, this program achieved survival outcomes comparable to international standards, with progressive improvement and sex-equitable results. Late mortality, rather than graft failure, has emerged as the main long-term challenge.
PMID:42273379 | PMC:PMC13246708 | DOI:10.3389/fneph.2026.1817080