title: Twenty-five-year survival of living related kidney transplants: thirty-five years' experience.
abstract: OBJECTIVE
  Although better graft survival in patients treated with CsA has been obtained, chronic rejection continues to be a common complication in renal transplantation. In this study, we examined the graft survivals and complications among renal transplant patients followed for more than 25 years.
  
  
  METHODS
  Between April 1970 and April 1979, 110 consecutive renal transplantations from living donors were performed in 110 patients. There were 83 men and 27 women of mean age of 27 +/- 7.0 years. A combination of azathioprine (AZ) and prednisolone (PSL) was used for the initial immunosuppressive therapy in all patients.
  
  
  RESULTS
  Over 25 years postoperatively, 41 patients died with or without a functioning graft due to complications including infections and malignancies. Therefore, the 25-year patient survival was 62.5% and 34 patients returned to hemodialysis, yielding an actual 25-year graft survival of 36/110 (32.1%). The longest surviving graft is 30 years and 2 months. The main causes of death were infectious disease and malignancy; 73% of graft loss was due to chronic rejection. Mean serum creatinine of the patient with functioning grafts over 25 years is 1.2 mg/dL; 75% of patients displayed a value under 1.5 mg/dL. The mean dosage of Az was 52.3 mg/d and PSL was 5.6 mg/d.
authors.affiliation: Department of Organ Transplant and Regenerative Surgery, Kyoto Prefectural University of Medicine, Graduate School of Medical Sciences, Kyoto City, Japan. nyoshi@koto.kpu-m.ac.jp
authors.forename: N
authors.initials: N
authors.lastname: Yoshimura
authors.forename: K
authors.initials: K
authors.lastname: Akioka
authors.forename: H
authors.initials: H
authors.lastname: Ushigome
authors.forename: Y
authors.initials: Y
authors.lastname: Kadotani
authors.forename: S
authors.initials: S
authors.lastname: Ogino
authors.forename: Y
authors.initials: Y
authors.lastname: Wakabayashi
authors.forename: A
authors.initials: A
authors.lastname: Higuchi
authors.forename: S
authors.initials: S
authors.lastname: Nobori
authors.forename: S
authors.initials: S
authors.lastname: Kaihara
authors.forename: M
authors.initials: M
authors.lastname: Okamoto
mesh_terms: D000328:Adult; D001379:Azathioprine / Q000627:therapeutic use; D003404:Creatinine / Q000097:blood; D004359:Drug Therapy, Combination; D005260:Female; D006085:Graft Survival / Q000502:physiology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000401:mortality / Q000502:physiology*; D019520:Living Donors; D008297:Male; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D007166:Immunosuppressive Agents; D003404:Creatinine; D001379:Azathioprine