[Factors predicting outcome in renal transplantation].
Organ shortage and necessity of good allocation to improve graft outcomes are well documented by epidemiological data. The authors analyze the main factors influencing long-term graft outcome concerning donor, peritransplant period and recipient. Donor age, marginal donors and new knowledges on donor brain death are the most relevant donor related factors. Cold ischemia is still a relevant peritransplant factor. Its influence on dentritic cell activation has been recently discovered. Regarding histocompatibility the six antigen match condition undoubtedly is associated to a better outcome. Most relevant recipient factors are: Preemptive transplant from living and deceased donors, whenever possible. With improvements in long-term kidney graft survival,the recurrence of original kidney disease is becoming an important cause of late graft failure. Recently several biological markers are emerging as graft outcome predictors. Recent findings indicate that certain cytokines or special lymphocyte subsets (alloreactive T memory cells) in the recipient could be powerful markers in the next future.
Bertoni
E
E
Nefrologia dei Trapianti e Dialisi, Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy.
Salvadori
M
M
D006801:Humans; D016030:Kidney Transplantation; D012307:Risk Factors; D014019:Tissue Donors; D016896:Treatment Outcome