The influence of mode of dialysis pretransplantation on long-term renal allograft outcome.
To determine the influence of the need and the mode of dialysis prior to transplantation on long-term renal allograft survival and subsequent renal function, all 662 consecutive cyclosporine-treated renal transplants (484 cadaver and 178 living-related donors), performed between 1983 and 1989 were retrospectively analyzed. Recipients were divided into 3 groups as follows: group I and II recipients underwent hemodialysis and peritoneal dialysis, respectively, prior to transplantation; group III patients were transplanted without dialysis. All groups were similar with respect to demographic and immunologic characteristics, apart from a higher proportion of diabetic and White patients in both cadaver and living-related group III recipients and a fewer number of blood transfusions among living-related group III recipients. A trend toward a decreased incidence of dialysis dependence in the early posttransplant period was noted among cadaver donor recipients in group III (20%) when compared to group I and II patients (36% and 26%, respectively). The incidence of rejection episodes was similar in all groups. No difference in 1- and 5-year patient survival was noted among all recipient groups. Actual 1-year graft survivals in groups I, II, and III were similar (73%, 72%, and 74%, respectively, for cadaver donor; and 86%, 89%, and 91%, respectively for living-related donor recipients). Likewise, actuarial 5-year graft survivals were not significantly different (53%, 51%, and 67%, respectively, for cadaver donor; and 75%, 69%, and 82%, for living-related donor recipients). Renal function, as assessed by serum creatinine concentration, was similar and stable in all recipient groups.(ABSTRACT TRUNCATED AT 250 WORDS)
Cacciarelli
T V
TV
Department of Surgery, State University of New York Health Science Center at Brooklyn, New York.
Sumrani
N B
NB
DiBenedetto
A
A
Hong
J H
JH
Sommer
B G
BG
D000206:Actuarial Analysis; D000328:Adult; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology; D006085:Graft Survival / Q000502:physiology*; D006801:Humans; D007165:Immunosuppression Therapy; D007676:Kidney Failure, Chronic / Q000601:surgery* / Q000628:therapy; D016030:Kidney Transplantation / Q000502:physiology* / Q000706:statistics & numerical data; D008297:Male; D010530:Peritoneal Dialysis; D006435:Renal Dialysis; D012189:Retrospective Studies; D013997:Time Factors; D014019:Tissue Donors
D016572:Cyclosporine