[Long-term results following kidney transplantation. An empirical analysis of 467 allogeneic kidney transplants concerning the effect of clinical and immunological variables on graft function].
In a homogeneous group of 467 cadaver kidney transplants performed within one single center between 1979 and 1987, we analysed the influence of main risk factors on long-term survival up to 72 months. Calculating survival rates by Kaplan-Meier actuarial methods the overall graft survival exceeded 71%. The corresponding patient survival was higher than 90%. A good HLA-A-B and DR match was of significant positive influence. Patients who received cyclosporine had a significant better outcome compared to conventional immunosuppressive therapy. A marked advantage was demonstrated for such variables as number of pretransplant blood transfusions, number of rejection episodes, preservation time and renal function as measured by plasma creatinine. Independently age was a main risk factor for curtailed graft survival. Although immunological factors accounted for more than 45% of transplant loss we found a surprisingly high percentage of infections (36%). Vascular problems or technical failure were below 10%. We conclude that a profound clinical examination in the pretransplant period is of high value and remains necessary to identify high risk patients in the long range.
Langer
K
K
Transplantationszentrum, Westfälischen Wilhelms-Universität Münster.
Buchholz
B
B
Raidt
H
H
Graefe
U
U
Lison
A E
AE
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood; D003524:Cyclosporins / Q000627:therapeutic use; D005260:Female; D006084:Graft Rejection; D006650:Histocompatibility Testing; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000276:immunology / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D016019:Survival Analysis
D003524:Cyclosporins; D007166:Immunosuppressive Agents; D003404:Creatinine
Langzeitergebnisse nach Nierentransplantation. Eine empirische Analyse von 467 allogenen Nierentransplantationen über den Einfluss klinischer und immunologischer Variablen auf die Transplantatfunktion.