The beneficial effect of blood transfusion and the DR 1 gene dose on renal transplant outcome in blacks.
We performed a retrospective analysis of the factors determining renal allograft survival in 70 black recipients from a single center and 1212 black recipients from multicenter registry data. One and two-year graft survival in single-center blacks was comparable to the result achieved in the general population (81% and 77%, respectively). Two-year graft survival in multicenter blacks was significantly worse than nonblacks (73% versus 55%, respectively; P less than 0.01). Graft survival in untransfused blacks receiving cyclosporine was no better than the result achieved during the azathioprine era. A beneficial effect upon graft survival was seen in blacks transplanted at the centers that have consistently displayed the best overall allograft survival over the years. Matching for HLA antigens was consistently poorer in blacks compared with whites and did not confer additive benefit over cyclosporine and blood transfusion. Our data indicate that cyclosporine immunosuppression, blood transfusion, and individual center expertise contribute significantly toward optimal transplant outcome in the higher-risk black end-stage renal disease population.
Ward
H J
HJ
Renal Transplant Section, Harbor-UCLA Medical Center, Torrance 90509.
Koyle
M A
MA
D000367:Age Factors; D000961:Antilymphocyte Serum / Q000276:immunology; D044383:Black People / Q000235:genetics; D001803:Blood Transfusion; D003524:Cyclosporins / Q000627:therapeutic use; D006085:Graft Survival; D015798:HLA-DR1 Antigen / Q000276:immunology*; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology*; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012737:Sex Factors; D016019:Survival Analysis
D000961:Antilymphocyte Serum; D003524:Cyclosporins; D015798:HLA-DR1 Antigen