Thirty-year trends in clinical kidney transplantation.
Trends in one-year graft survival rates seen in the past 30 years were examined in the UCLA and UNOS Registries. Some of the trends noted were as follows: 1. One-year graft survival rates for cadaver-donor transplants improved from 40% to 80% during this 30-year period. One-year patient survival improved from 50% to 95%. Transplants from living-related donors improved in graft survival from 80% to 90-95%. 2. Factors that diminished in importance were: recipient race, sensitization, primary disease, HLA haplotype matching in living donors, recipient and donor sex, kidney sharing, and transfusions. 3. Factors that continue to provide about a 10% variation of one-year graft survival are: cold ischemia time, HLA mismatch, recipient and donor age. 4. Posttransplantation, factors such as first-day diuresis, one-week dialysis, rejection at discharge, and discharge serum creatinine continue to be very important determinants of future outcome in 6 yearly subsets of patients. 5. Induction by ALG and OKT3 was shown in 6 subsets to have no effect on one-year graft survival. 6. Future trend studies will be needed to examine the 5-year long-term effects.
Terasaki
P I
PI
Yuge
J
J
Cecka
J M
JM
Gjertson
D W
DW
Takemoto
S
S
Cho
Y
Y
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D005260:Female; D006085:Graft Survival; D006650:Histocompatibility Testing; D006801:Humans; D007511:Ischemia / Q000503:physiopathology; D007668:Kidney / Q000098:blood supply; D016030:Kidney Transplantation / Q000706:statistics & numerical data / Q000639:trends*; D008297:Male; D008875:Middle Aged; D009926:Organ Preservation; D014019:Tissue Donors