Late mortality and morbidity five to eighteen years after kidney transplantation.
The experience with 102 kidney transplants (86 from cadaver donors) functioning more than 5 years in 99 patients followed in one center is reviewed. With the 100% survival point set at 5 years, patient and graft survivals were 92% and 73% at 10 years, and 70% and 56% at 15 years, respectively. Of those 102 recipients, 58 are presently alive with a functioning graft and 18 died with a functioning graft; 26 patients rejected their graft after a mean interval of 8.3 years posttransplant, 11 of them died within 4-45 months following readmission to dialysis. For the whole group, 29 patients died after a mean period of 10 years following transplantation. Main causes of death were vascular catastrophes (48%), malignancies (21%), sepsis (17%), and liver failure (14%). Because vascular accidents, hepatic failure, and sepsis predominated in male patients, the overall late mortality was higher in male (37%) than in female (25%) patients. The high incidence of late complications--including chronic and acute graft rejections--in long-term kidney recipients constitutes a strong argument for maintaining constant supervision of those patients by a medical team with extensive experience with transplantation.
Toussaint
C
C
Département Médico-Chirurgical de Néphrologie, Dialyse, et Transplantation, Cliniques Universitaires de Bruxelles, Hôpital, Erasme, Belgium.
Kinnaert
P
P
Vereerstraeten
P
P
D000328:Adult; D000368:Aged; D002561:Cerebrovascular Disorders / Q000209:etiology; D005260:Female; D006084:Graft Rejection; D006801:Humans; D016030:Kidney Transplantation; D008107:Liver Diseases / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D014184:Transplantation, Homologous / Q000009:adverse effects / Q000401:mortality*; D014652:Vascular Diseases / Q000209:etiology