The UNOS Scientific Renal Transplant Registry--1990.
Based upon data reported to the UNOS Scientific Renal Transplant Registry between October 1987 and October 1990: 1. One-year graft survival rates were 78% for 14,203 recipients of first cadaver donor transplants, 70% for 2180 recipients of second cadaver transplants, and 59% for 487 recipients of third or fourth transplants. First transplants from living donors had 90% 1-year graft survival. 2. One-year graft survival was 75% for 2,273 Black recipients of first cadaver transplants and ranged between 79-80% for recipients of other races (p less than 0.001). 3. Broadly sensitized (50% peak PRA) first cadaver transplant recipients had 77% 1-year graft survival versus 79% for nonsensitized or narrowly sensitized recipients. Cadaver retransplant recipients with greater than 10% peak PRA had 65% 1-year graft survival while those transplanted with no antibody had 78% (p less than 0.001). Survival of nonsensitized retransplanted patients was not significantly less than first transplant recipients. 4. Graft survival was 78% at 1 year for both male and female recipients of first cadaver donor transplants. Retransplanted females had significantly higher 1-year graft survival at 70% than males at 67% (p less than 0.01). Male donor kidneys had significantly higher survival rates than female donor kidneys in both first and retransplanted patients. One-year graft survival was 79% and 70% with male donors and 75% and 65% with female donors in first and retransplants, respectively (p less than 0.01). 5. Pediatric recipients (under 16) and older recipients (over 60) of first cadaver transplants had 73% 1-year graft survival compared to 78-79% for those aged 16-60. 6. Among recipients of first cadaver transplants, 1-year graft survival rates varied over a 20% range with the age of the donor. Excluding pediatric and older patients, the best survival rates (81%) were obtained with kidneys from donors aged 16-45. Kidneys from younger and older donors yielded progressively poorer results. The lowest survival was with 181 donors aged 1-5 (60%) and 145 donors over 60 (69%). 7. One-year graft survival was 85% for 274 recipients of 0 HLA-A,B,DR-mismatched first cadaver transplants and 74% for 717 recipients of transplants mismatched for 6 HLA-A,B,DR antigens. Graft survival progressively declined with increasing histoincompatibility. 8. One-year graft survival decreased by 20% if the kidney failed to produce urine in the first hour, from 80-60% in first transplant recipients and from 72-50% in retransplanted patients.(ABSTRACT TRUNCATED AT 400 WORDS)
Cecka
J M
JM
UCLA Tissue Typing Laboratory.
Terasaki
P I
PI
D002102:Cadaver; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006650:Histocompatibility Testing; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology; D012042:Registries; D009927:Tissue and Organ Procurement / Q000458:organization & administration*; D014481:United States