title: Kidney transplantation at the University of Miami.
abstract: Of the 1,679 renal allografts performed at the University of Miami between January 1, 1979 and October 31, 1999, 1,154 were from cadaver donors (CAD), 515 were from living-related donors (LRD), and 10 were from living-unrelated donors. The 3 ethnic groups: Black Caribbean-African-American, Hispanic, and others were almost equally represented among recipients. Recipient ages ranged between 1-83 years. In the CAD group, HLA matching was emphasized so that no patient received a kidney with less than one DR match, and for the entire series a mean of 2.59 of 6 HLA antigens were matched between donors and recipients. Overall actuarial 20-year patient and graft survival rates were 65.3% and 30.7%, respectively, with 69.2% patient and 38.5% graft survival rates for LRD, and 65.6% patient and 29.0% graft survival rates for CAD recipients. Several factors adversely affected long-term graft outcome. African-Americans had an overall 20-year graft survival rate of 13.6% compared with 34% for non African-Americans (p < 0.001) (not dependent on patient survival). Diabetic patients had an overall 20-year graft survival rate of 13.5% versus 34.2% for non-diabetics (primarily dependent on patient survival). In the category of non African-American, non-diabetic patients under age 36 (n = 412), the 20-year patient survival rates in the LRD and CAD groups were 85.0% and 79.3%, respectively, and the graft survival rates were 55.7% and 46.5%, respectively. This differed markedly from the results for the entire series.
authors.affiliation: Department of Surgery, University of Miami School of Medicine, Florida, USA.
authors.forename: G
authors.initials: G
authors.lastname: Ciancio
authors.forename: N
authors.initials: N
authors.lastname: Contreras
authors.forename: V
authors.initials: V
authors.lastname: Esquenazi
authors.forename: C
authors.initials: C
authors.lastname: Gomez
authors.forename: H
authors.initials: H
authors.lastname: Gharagozloo
authors.forename: G W
authors.initials: GW
authors.lastname: Burke
authors.forename: R
authors.initials: R
authors.lastname: Garcia-Morales
authors.forename: L
authors.initials: L
authors.lastname: Olson
authors.forename: A
authors.initials: A
authors.lastname: Rosen
authors.forename: J
authors.initials: J
authors.lastname: Colona
authors.forename: D
authors.initials: D
authors.lastname: Roth
authors.forename: J
authors.initials: J
authors.lastname: Strauss
authors.forename: C
authors.initials: C
authors.lastname: Ricordi
authors.forename: J
authors.initials: J
authors.lastname: Miller
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000368:Aged; D044383:Black People; D002102:Cadaver; D002648:Child; D005431:Florida; D005500:Follow-Up Studies; D006085:Graft Survival; D006785:Hospitals, University; D006801:Humans; D016030:Kidney Transplantation / Q000401:mortality / Q000502:physiology / Q000706:statistics & numerical data*; D008875:Middle Aged; D044469:Racial Groups; D012189:Retrospective Studies; D015996:Survival Rate; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000458:organization & administration; D016896:Treatment Outcome; D014850:Waiting Lists; D044465:White People