Utilization of the Charlson Comorbidity Score to Predict 10-Year Survival in Renal Transplant Recipients

Purpose: The Charlson Comorbidity Score has been demonstrated to predict mortality in prostate cancer patients. Our novel objective was to compare the 10-year observed mortality with expected mortality based on pre-operative Charlson Score adjusted for resolution of renal disease in patients undergoing renal transplantation at our institution. Materials and Methods: We reviewed the records of 100 consecutive patients receiving a first renal transplant at our center between 2004 and 2005. Inclusion criteria were kidney only transplant with follow-up until death or 10 years post-transplant. Age, sex, etiology of renal failure, months on dialysis pre-transplant, comorbidities, survival at 10 years or months from transplant to death were collected. A Charlson Score adjusted for resolution of renal disease was determined and probability of survival at 10 years was calculated from this. Cox proportional hazards modeling was used to determine independent factors predictive of patient survival. Kaplan Meier Curves were generated to demonstrate 10- year survival. Results: Mean 10 year predicted survival was 72.5% (CI 66-78.8) and actual survival was 77% (CI 68.6 - 85.4).The only significant predictive variable of survival was predicted 10-year survival based on the Charlson Score (HR 0.9758, p <0.0001). Conclusions: After accounting for the resolution of renal failure with renal transplantation, the predicted 10-year survival based on the Charlson Comorbidity Score was predictive of actual patient survival.