Factors influencing long-term primary cadaveric kidney transplantation--importance of functional renal mass versus avoidance of acute rejections--the Toronto Hospital experience 1985-1997.
1. The 5-year actuarial graft, patient and functional graft survival rates were analyzed in 743 consecutive primary cadaveric kidney transplants from The Toronto Hospital between January 1985-December 1997. 2. Recipient age > or = 55 years, male recipient sex, recipient diabetes mellitus, CIT > 36 hours and delayed graft function were found to significantly decrease patient survival. 3. Recipient age > or = 55 years, sensitization to HLA antigens (peak PRA > 50%), donor/recipient HLA antigen mismatches, CIT > 36 hours, delayed graft, function and 6-month SCr > 200 mumol/L were found to significantly decrease graft survival. 4. Acute rejection episodes had no significant impact on overall 5-year patient or graft survival. 5. The observation that serum creatinine > 200 mumol/L had a major adverse influence on long-term outcome reflects the importance of functional renal mass on graft survival.
Geddes
C C
CC
Multi Organ Transplant Unit, Toronto Hospital, University of Toronto, Ontario, Canada.
Cole
E
E
Wade
J
J
Cattran
D
D
Fenton
S
S
Robinette
M
M
Stewart
R
R
Hemming
A
A
Cattral
M
M
Garcia
A
A
Cardella
C J
CJ
D000328:Adult; D000367:Age Factors; D002102:Cadaver; D003928:Diabetic Nephropathies / Q000601:surgery; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control*; D006085:Graft Survival; D006650:Histocompatibility Testing; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D007674:Kidney Diseases / Q000601:surgery; D016030:Kidney Transplantation / Q000401:mortality / Q000502:physiology / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009864:Ontario; D012189:Retrospective Studies; D015996:Survival Rate; D014019:Tissue Donors