{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T07:02:27Z","timestamp":1779778947737,"version":"3.53.1"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nephrol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Kidney transplantation remains the most effective therapy for End-Stage Renal Disease. While global outcomes have improved, data from Latin America are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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\u2013Meier and competing-risk models, and compared across three transplant eras (2006\u20132011, 2012\u20132018, 2019\u20132025).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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\u2013Meier analyses showed no sex differences; 1-year patient survival was 92.1% (95% CI: 87.8\u201394.9) in males and 96.7% (95% CI: 92.3\u201398.6) 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\u201396.7) in 2019\u20132025 (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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneph.2026.1817080","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T06:04:22Z","timestamp":1779775462000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Experience and outcomes of kidney transplantation in a Colombian referral center"],"prefix":"10.3389","volume":"6","author":[{"given":"Maricel","family":"Licht-Ardila","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Hospital Internacional de Colombia HIC- Fundaci\u00f3n Cardiovascular de Colombia FCV- Fundaci\u00f3n Universitaria FCV","place":["Piedecuesta, Santander, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana Carolina","family":"Velasquez-Romero","sequence":"additional","affiliation":[{"name":"Universidad Aut\u00f3noma de Bucaramanga - UNAB, Facultad de Ciencias de la Salud","place":["Bucaramanga, Santander, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Hurtado-Ortiz","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Hospital Internacional de Colombia HIC- Fundaci\u00f3n Cardiovascular de Colombia FCV- Fundaci\u00f3n Universitaria FCV","place":["Piedecuesta, Santander, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandra","family":"Mendoza-Monsalve","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Hospital Internacional de Colombia HIC- Fundaci\u00f3n Cardiovascular de Colombia FCV- Fundaci\u00f3n Universitaria FCV","place":["Piedecuesta, Santander, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine del Consuelo","family":"Camargo-Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Universidad Aut\u00f3noma de Bucaramanga - UNAB, Facultad de Ciencias de la Salud","place":["Bucaramanga, Santander, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia Constanza","family":"Velasco-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Kidney Transplant Unit, Hospital Internacional de Colombia HIC- Fundaci\u00f3n Cardiovascular de Colombia FCV- Fundaci\u00f3n Universitaria FCV","place":["Piedecuesta, Santander, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adalberto","family":"Pe\u00f1a Wilches","sequence":"additional","affiliation":[{"name":"Kidney Transplant Unit, Hospital Internacional de Colombia HIC- Fundaci\u00f3n Cardiovascular de Colombia FCV- Fundaci\u00f3n Universitaria FCV","place":["Piedecuesta, Santander, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola Andrea","family":"Parra","sequence":"additional","affiliation":[{"name":"Kidney Transplant Unit, Hospital Internacional de Colombia HIC- Fundaci\u00f3n Cardiovascular de Colombia FCV- Fundaci\u00f3n Universitaria FCV","place":["Piedecuesta, Santander, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anderson","family":"Bermon","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Hospital Internacional de Colombia HIC- Fundaci\u00f3n Cardiovascular de Colombia FCV- Fundaci\u00f3n Universitaria FCV","place":["Piedecuesta, Santander, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Sebastian","family":"Gelvez-Rueda","sequence":"additional","affiliation":[{"name":"Kidney Transplant Unit, Hospital Internacional de Colombia HIC- Fundaci\u00f3n Cardiovascular de Colombia FCV- Fundaci\u00f3n Universitaria FCV","place":["Piedecuesta, Santander, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edgar Fabi\u00e1n","family":"Manrique-Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Hospital Internacional de Colombia HIC- Fundaci\u00f3n Cardiovascular de Colombia FCV- Fundaci\u00f3n Universitaria FCV","place":["Piedecuesta, Santander, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilmer Roberto","family":"Rivero-Rodrigez","sequence":"additional","affiliation":[{"name":"Kidney Transplant Unit, Hospital Internacional de Colombia HIC- Fundaci\u00f3n Cardiovascular de Colombia FCV- Fundaci\u00f3n Universitaria FCV","place":["Piedecuesta, Santander, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,26]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2004.00332.x","article-title":"Lack of improvement in renal allograft survival despite a marked decrease in acute rejection rates over the most recent era","volume":"4","author":"Meier-Kriesche","year":"2004","journal-title":"Am J Transplant"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajt.2023.07.006","article-title":"Survival after kidney transplantation compared with ongoing dialysis for people over 70 years of age: a matched-pair analysis","volume":"23","author":"Shi","year":"2023","journal-title":"Am J Transplant"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1007\/s40472-024-00438-4","article-title":"Renal transplantation in older adults: an updated review","volume":"11","author":"Black","year":"2024","journal-title":"Curr Transplant Rep"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12154916","article-title":"Emerging therapies for antibody-mediated rejection in kidney transplantation","volume":"12","author":"Abuazzam","year":"2023","journal-title":"J Clin Med"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.3389\/ti.2025.14343","article-title":"Targeting CD38 in antibody-mediated rejection","volume":"38","author":"Mayer","year":"2025","journal-title":"Transpl Int"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.nefroe.2025.03.002","article-title":"Spanish registry of renal patients: 2022 report and evolutive analysis","volume":"45","year":"2025","journal-title":"Nefrologia"},{"key":"B7","volume-title":"2024 USRDS annual data report: epidemiology of kidney disease in the United States","year":"2024"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3389\/ti.2024.12942","article-title":"Characteristics of early antibody-mediated rejection in antibody incompatible living donor kidney transplantation","volume":"37","author":"Punjala","year":"2024","journal-title":"Transpl Int"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12154927","article-title":"Current therapies in kidney transplant rejection","volume":"12","author":"Alasfar","year":"2023","journal-title":"J Clin Med"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2022.11.014","article-title":"Clinical outcomes in living donor kidney transplantation: a single-center experience in Latin America","volume":"55","author":"Baez-Suarez","year":"2023","journal-title":"Transplant Proc"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2018.05.018","article-title":"Analyses of the short- and long-term graft survival after kidney transplantation in Europe between 1986 and 2015","volume":"94","author":"Coemans","year":"2018","journal-title":"Kidney Int"},{"key":"B12","doi-asserted-by":"publisher","first-page":"S19","DOI":"10.1016\/j.ajt.2024.01.012","article-title":"OPTN\/SRTR 2022 annual data report: kidney","volume":"24","author":"Lentine","year":"2024","journal-title":"Am J Transplant"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.3389\/ti.2022.10315","article-title":"Is preemptive kidney transplantation associated with improved outcomes compared to non-preemptive transplantation in children? A systematic review and meta-analysis","volume":"35","author":"Magar","year":"2022","journal-title":"Transpl Int"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap): a metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"Harris","year":"2009","journal-title":"J BioMed Inform"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208","article-title":"The REDCap consortium: building an international community of software platform partners","volume":"95","author":"Harris","year":"2019","journal-title":"J BioMed Inform"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajt.2023.10.016","article-title":"The Banff 2022 kidney meeting report: reappraisal of microvascular inflammation and the role of biopsy-based transcript diagnostics","volume":"24","author":"Naesens","year":"2024","journal-title":"Am J Transplant"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0269990","article-title":"Risk factors for graft loss and death among kidney transplant recipients: a competing risk analysis","volume":"17","author":"Pinto-Ramirez","year":"2022","journal-title":"PloS One"},{"key":"B18","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1093\/ndt\/gfad137","article-title":"Sex differences in the survival benefit of kidney transplantation: a retrospective cohort study using target trial emulation","volume":"39","author":"Geroldinger","year":"2024","journal-title":"Nephrol Dial Transplant"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.962094","article-title":"Graft survival differences in kidney transplants related to recipient sex and age","volume":"9","author":"Sancho","year":"2022","journal-title":"Front Med (Lausanne)"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1016\/j.semnephrol.2022.04.011","article-title":"Sex and gender differences in kidney transplantation","volume":"42","author":"Katz-Greenberg","year":"2022","journal-title":"Semin Nephrol"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.3389\/fneph.2024.1360856","article-title":"Gender and kidney transplantation","volume":"4","author":"Nautiyal","year":"2024","journal-title":"Front Nephrol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1038\/s41581-023-00784-z","article-title":"Differences in the epidemiology, management and outcomes of kidney disease in men and women","volume":"20","author":"Chesnaye","year":"2024","journal-title":"Nat Rev Nephrol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1016\/j.nefro.2021.09.004","article-title":"CKD: the burden of disease invisible to research funders","volume":"42","year":"2022","journal-title":"Nefrologia"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e3182336095","article-title":"Effect of smoking on kidney transplant outcomes: analysis of the United States Renal Data System","volume":"92","author":"Hurst","year":"2011","journal-title":"Transplantation"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfae081","article-title":"Better kidney allograft survival despite higher-risk donor and recipient characteristics between 1995 and 2014","volume":"39","author":"Ng","year":"2024","journal-title":"Nephrol Dial Transplant"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.16463","article-title":"Long-term kidney transplant graft survival\u2014making progress when most needed","volume":"21","author":"Poggio","year":"2021","journal-title":"Am J Transplant"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfz053","article-title":"Cardiovascular disease in the kidney transplant recipient: epidemiology, diagnosis and management strategies","volume":"34","author":"Rangaswami","year":"2019","journal-title":"Nephrol Dial Transplant"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0316418","article-title":"Association of healthcare fragmentation with three-year survival among kidney transplant recipients in Colombia","volume":"20","author":"Barrera-Lozano","year":"2025","journal-title":"PloS One"},{"key":"B29","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1186\/s41100-019-0199-6","article-title":"Trends of kidney transplantation in Japan in 2018: data from the kidney transplant registry","volume":"5","author":"Yagisawa","year":"2019","journal-title":"Ren Replace Ther"}],"container-title":["Frontiers in Nephrology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneph.2026.1817080\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T06:04:25Z","timestamp":1779775465000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneph.2026.1817080\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,26]]},"references-count":29,"alternative-id":["10.3389\/fneph.2026.1817080"],"URL":"https:\/\/doi.org\/10.3389\/fneph.2026.1817080","relation":{},"ISSN":["2813-0626"],"issn-type":[{"value":"2813-0626","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,26]]},"article-number":"1817080"}}