title: Living-donor kidney transplantation: the Freiburg experience.
abstract: OBJECTIVE
  The objective of this study was to determine outcome after living-donor kidney transplantation in a single-center institution in Germany.
  
  
  METHODS
  From 1976 to May 2005, a total of 298 living-donor kidney transplants were performed at the University of Freiburg. Most recipients (78.8%) were placed on cyclosporine, mycophenolate mofetil, and corticosteroids maintenance immunosuppression. Cox proportional hazard model was applied to analyze predictors for patient and graft survival. Mean follow-up was 5.3 years.
  
  
  RESULTS
  According to Kaplan-Meier calculation, 1-, 5-, and 10-year patient survival was 98.6, 92.7, and 86.8%, respectively. Kidney function rate was 95.5, 82.8, and 67.9%, respectively. A 5-year graft function rate continued to increase from 79.5% in patients transplanted before 1996 to 83.6% in patients transplanted thereafter. In a Cox regression model recipient age above 50 years, duration of dialysis above 2 years and preexisting type 1 diabetes mellitus were associated with a decreased patient survival. Graft survival was mostly influenced by the type of immunosuppression and preexisting hypertension of the recipient.
  
  
  CONCLUSIONS
  Our results demonstrate that living-donor kidney transplantation is a highly effective therapy for patients with end stage renal failure. Updates in immunosuppression, recipient selection, and operative technique may have contributed to the improved graft survival over the past three decades.
authors.affiliation: Department of General and Digestive Surgery, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg i. Brsg., Germany. oliverdrognitz@web.de
authors.forename: Oliver
authors.initials: O
authors.lastname: Drognitz
authors.forename: Johannes
authors.initials: J
authors.lastname: Donauer
authors.forename: Judith
authors.initials: J
authors.lastname: Kamgang
authors.forename: Peter
authors.initials: P
authors.lastname: Baier
authors.forename: Hannes
authors.initials: H
authors.lastname: Neeff
authors.forename: Christian
authors.initials: C
authors.lastname: Lohrmann
authors.forename: Martin
authors.initials: M
authors.lastname: Pohl
authors.forename: Ulrich Theodor
authors.initials: UT
authors.lastname: Hopt
authors.forename: Günter
authors.initials: G
authors.lastname: Kirste
authors.forename: Przemyslaw
authors.initials: P
authors.lastname: Pisarski
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood; D005260:Female; D005858:Germany; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation / Q000379:methods* / Q000706:statistics & numerical data; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D003404:Creatinine