[Cadaver renal transplantation and multivariate analysis for graft survival: a clinical review of 2 016 cases].
OBJECTIVE
To review kidney transplantation in the center and analyze the risk factors affecting long-term allograft survival.


METHODS
Thirty-two relative variables were analyzed with SAS statistical software. Using Log-rank method, we investigated influence of these variables on short-and long-term survival of grafts. Kaplan-Meier analysis was used to estimate the 1-, 3-, 5-, 10-years graft survival rates and half-life. Proportional hazards regression analysis (Cox model) was used to assess and rank the relative risk of potential variables.


RESULTS
The 1-, 3-, 5-, 10-years graft survival rates were 83%, 75%, 66% and 48%. After excluding the patients died with functioning grafts, the 1-, 3-, 5-, 10 years grafts survival rate increased to 89%, 82%, 75% and 69%, respectively. The mean half-life was 8.78 +/- 0.14 and 14.09 +/- 0.20 years, respectively. By Log-rank analysis, factors affecting short- and long-term graft survival were identified as: renal function, duration of graft function became normal, cold-ischemia time, presence of acute rejection, delayed graft function, immunosuppressive regimen, complication, infection, anti-rejection therapy. Cox model multivariate analysis showed that there were 18 factors affecting graft survival.


CONCLUSIONS
New immunosuppressive agents not only significantly increase short-term graft survival, but also have the better long-term outcome tendency. Making assurance to get high quality donor organ and minimizing the death with graft function may be the most feasible way to prolong graft survival at present.
Qi
Jun
J
Renal Transplantation Center, Changzheng Hospital, Shanghai 200003, China. jun-qcn@yahoo.com.cn
Min
Zhilian
Z
Zhu
Youhua
Y
Liu
Yushan
Y
Lu
Jian
J
Wang
Liming
L
Wang
Yawei
Y
Ren
Jizhong
J
Zheng
Junhua
J
Xu
Danfeng
D
Zhou
Meisheng
M
Yao
Yacheng
Y
Gao
Yi
Y
D000328:Adult; D002102:Cadaver; D005260:Female; D006085:Graft Survival / Q000187:drug effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology; D016030:Kidney Transplantation; D008297:Male; D015999:Multivariate Analysis; D014184:Transplantation, Homologous
D007166:Immunosuppressive Agents