Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 3 2014 03 15 316 22 Moghaddameh Mirzaee 1. Dept. of Epidemiology and Biostatistics, Tehran University of Medical Sciences , Tehran, Iran. Kazem Mohammad 1. Dept. of Epidemiology and Biostatistics, Tehran University of Medical Sciences , Tehran, Iran. Mahmood Mahmoodi 1. Dept. of Epidemiology and Biostatistics, Tehran University of Medical Sciences , Tehran, Iran. Hojjat Zeraati 1. Dept. of Epidemiology and Biostatistics, Tehran University of Medical Sciences , Tehran, Iran. Mohammad-Reza Ebadzadeh 2. Physiology Research Center, Departments of Nephrology, Urology and Renal Transplantation, Kerman University of Medical Sciences , Kerman, Iran. Abbas Etminan 2. Physiology Research Center, Departments of Nephrology, Urology and Renal Transplantation, Kerman University of Medical Sciences , Kerman, Iran. Faramarz Fazeli 3. Dept. of Urology, Zahedan University of Medical Sciences , Zahedan, Iran. Mohammad Hasan Dehghani Firouzabadi 2. Physiology Research Center, Departments of Nephrology, Urology and Renal Transplantation, Kerman University of Medical Sciences , Kerman, Iran. Hossein Sattary 2. Physiology Research Center, Departments of Nephrology, Urology and Renal Transplantation, Kerman University of Medical Sciences , Kerman, Iran. Mahdiyeh Haghparast 2. Physiology Research Center, Departments of Nephrology, Urology and Renal Transplantation, Kerman University of Medical Sciences , Kerman, Iran. Abbas Rahimi Foroushani 1. Dept. of Epidemiology and Biostatistics, Tehran University of Medical Sciences , Tehran, Iran. 2015 10 15 Renal transplantation is a therapy for end-stage renal disease. During the study of recipients' survival after renal transplantation, there are some events as intermediate events that not only affect the recipients' survival but also events which are affected by various factors. The aim of this study was to handle these intermediate events in order to identify factors that affect recipients' survival by using multi-state models.This retrospective cohort study included 405 renal transplant patients from Afzalipour Hospital, Kerman, Iran, from 2004 to 2010. The survival time of these recipients was determined after transplantation and the effect of various factors on the death hazard with and without renal allograft failure and hazard of renal allograft failure was studied by using multi-state models.During 4.06 years (median) of follow-up; 28 (6.9%) recipients died and allograft failure occurred in 51 (12.6%) recipients. Based on the results of multi-state model, receiving a living kidney transplantation decreased the hazard of renal allograft failure (HR=0.38; 95% CI: 0.17- 0.87), pre-transplant hypertension (HR=2.94; 95% CI: 1.54- 5.63) and serum creatinine levels >1.6 upon discharge from the hospital (HR=7.38; 95% CI: 3.87- 7.08) increased the hazard of renal allograft failure. Receiving living kidney transplantation decreased the hazard of death directly (HR=0.18; 95% CI: 0.04- 0.93).It was concluded that the effect of donor type, pre-transplant hypertension and having serum creatinine >1.6 upon discharge from the hospital was significant on hazard of renal allograft failure. The only variable that had a direct significant effect on hazard of death was donor type. https://ijph.tums.ac.ir/index.php/ijph/article/view/4190 https://ijph.tums.ac.ir/index.php/ijph/article/download/4190/3847