Deduction of the fraction of immunologic and non-immunologic failure in cadaver donor transplants.
We utilized the UNOS Registry graft survival records to determine the fraction of graft failures attributable to immunological or non-immunological factors. Ten-year graft survival of HLA-identical sibling donor grafts was 77% excluding deaths, diabetics, Black recipients, recipients older than age 50, and those who required post-transplant dialysis. With similar exclusions, 10 year graft survival from living HLA-mismatched donors was 66%. To account for the overall 60% graft failures at 10 years for all cadaver donors, we deduced that 38% of the failures were due to immunological reactions against non-HLA factors as seen in HLA-identical sibling grafts; 18% of failures were due to HLA factors, as seen in mismatched living donor grafts; and the remainder of 43% was attributable to non-immunological factors.
Terasaki
Paul I
PI
Terasaki Foundation Laboratory, Los Angeles, USA.
D000367:Age Factors; D001835:Body Weight; D002102:Cadaver; D015925:Cryopreservation; D006085:Graft Survival; D006801:Humans; D007674:Kidney Diseases / Q000208:ethnology / Q000601:surgery; D016030:Kidney Transplantation / Q000276:immunology* / Q000706:statistics & numerical data*; D012042:Registries; D012737:Sex Factors; D013997:Time Factors; D014019:Tissue Donors / Q000706:statistics & numerical data*; D017211:Treatment Failure