Living-donor kidney transplantation: the Freiburg experience.
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.
Drognitz
Oliver
O
Department of General and Digestive Surgery, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg i. Brsg., Germany. oliverdrognitz@web.de
Donauer
Johannes
J
Kamgang
Judith
J
Baier
Peter
P
Neeff
Hannes
H
Lohrmann
Christian
C
Pohl
Martin
M
Hopt
Ulrich Theodor
UT
Kirste
Günter
G
Pisarski
Przemyslaw
P
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
D007166:Immunosuppressive Agents; D003404:Creatinine