Results of 250 consecutive cadaver kidney transplants.
The results of 250 cadaver kidney transplants performed at this hospital between May 1968 and December 1974 were analysed. A functioning transplant was defined strictly as one that maintained the recipient in good health with a serum creatinine below 442 mumol/1 (5 mg/100 ml) without any need for dialysis. The proportions of kidneys functioning after one, two, and three years were 40-4%, 33-9%, and 31-1% respectively, the corresponding survival rates of patients being 62-6%, 57-4%, and 43-8%. The primary failure rate overall was 21-6%, while the failure rates for first, second, and third transplants were 18-1%, 39-9%, and 66-7% respectively. Half of the primary failures were attributed to the use of cadaver kidneys with abnormal vasculature or long ischaemic times or originating from non-ventilated donors. Of the initially successful transplants 49% were subsequently lost due to rejection (53%) or death of the patient with a functioning transplant (46%), and of the secondary losses 58% occurred within three months of transplantation. HLA matching of donor and recipient for two or more antigens was associated with a significant increase in transplant survival--46% at three years as opposed to 9-5% at three years for kidneys with poorer matches.
D000293:Adolescent; D000328:Adult; D000368:Aged; D002102:Cadaver; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood; D005260:Female; D006084:Graft Rejection; D006680:HLA Antigens; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000209:etiology; D011183:Postoperative Complications; D018805:Sepsis / Q000209:etiology; D013927:Thrombosis / Q000209:etiology; D013997:Time Factors; D014022:Tissue Survival; D014184:Transplantation, Homologous / Q000401:mortality
D006680:HLA Antigens; D003404:Creatinine