title: Factors affecting the long-term renal allograft survival.
abstract: BACKGROUND
  In the past decades, the one-year graft survival of cadaveric renal allografts has been markedly improved, but their long-term survival has not kept pace. The attrition rate of renal allografts surviving after one year remains almost unchanged. The causes for late graft loss are multiple. The aim of this study was to analyze the predictive factors that impact long-term survival of grafts after kidney transplantation.
  
  
  METHODS
  We retrospectively analyzed 524 kidney transplantation patients who were treated in our hospital between January 1991 and January 2000, including 254 patients who had lived more than 10 years with normal graft function (long survival group), and 270 cases whose renal graft had survived less than 10 years (control group). Specifically, we analyzed 10 factors that may potentially affect graft survival by both univariate and Logistic model multivariate analyses to pinpoint the independent risk factors.
  
  
  RESULTS
  Univariate analyses showed that no significant differences existed in the age or gender of recipients, dialysis time, lymphotoxin levels, or cold ischemia time between the two groups. However, the ratio of delayed graft function and acute rejection, and the uric acid levels of patients in the long survival group were significantly lower than those in the control group (P < 0.01). Furthermore, we found that the concentration of cyclosporin A at one year after transplantation and the histocompatibility antigen match of donor-recipients for patients within the long survival group were significantly higher than those in the control group (P < 0.01). Furthermore, multivariate analyses showed that these four factors were independent risk factors that impact patient survival.
  
  
  CONCLUSIONS
  The ratios of delayed graft function and acute rejection, the concentration of cyclosporin A at one year after transplantation, and serum uric acid levels are very important factors that affect the long-term survival of renal grafts.
authors.affiliation: Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.forename: Xiao-bei
authors.initials: XB
authors.lastname: Li
authors.forename: Hang
authors.initials: H
authors.lastname: Yin
authors.forename: Xiao-yong
authors.initials: XY
authors.lastname: Yang
authors.forename: Hang
authors.initials: H
authors.lastname: Liu
authors.forename: Liang
authors.initials: L
authors.lastname: Ren
authors.forename: Xiao-peng
authors.initials: XP
authors.lastname: Hu
authors.forename: Yong
authors.initials: Y
authors.lastname: Wang
authors.forename: Xiao-dong
authors.initials: XD
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006084:Graft Rejection / Q000175:diagnosis / Q000209:etiology*; D006085:Graft Survival / Q000502:physiology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents