[Kidney transplantation: consecutive one thousand transplants at National Institute of Medical Sciences and Nutrition Salvador Zubirán in Mexico City].
BACKGROUND
The National Institute of Medical Sciences and Nutrition Salvador Zubiran (INCMNSZ) is a specialty hospital for adults and a teaching hospital, which performed the first kidney transplant in 1967; in 1971 it began the formal program of renal transplantation. Recently, it was performed the kidney transplant number 1000, so this article presents the information of these thousand kidney transplants, with special emphasis on survival.


METHODS
Retrospective cohort study which included 1000 consecutive transplants performed at the INCMNSZ between 1967 and June 2011. It describes the general characteristics of kidney transplant recipients, transplant-related variables, initial immunosuppression and complications. Descriptive statistics were used. The survival analysis was performed using the Kaplan-Meier method. It shows the patient survival, graft survival censored for death with functional graft and total graft survival (uncensored).


RESULTS
Patient survival at 1, 3, 5, 10, 15, and 20 years was 94.9, 89.6, 86.8, 76.9, 66.1, and 62.2%, respectively. Graft survival censored for death with functional graft at 1, 3, 5, 10, 15, and 20 years was 93.1, 87.1, 83.5, 73.9, 62.7, and 52.5% respectively. Risk factors associated with poorer graft survival were younger age of the recipient, transplant during the first period (1967-1983), and a HLA mismatch.


CONCLUSIONS
Patient and graft survival have improved over time through the use of better immunosuppression and use of induction therapy. Identification of risk factors affecting graft survival, allows each center to set their strategies to improve the patient's outcome.
Departamento de Nefrología y Metabolismo Mineral, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, DF México.
Lluvia Aurora
LA
Marino-Vazquez
Regina
R
Sánchez-Ugarte
Luis Eduardo
LE
Morales-Buenrostro
D000328:Adult; D015331:Cohort Studies; D005260:Female; D006085:Graft Survival; D006268:Health Facilities; D006801:Humans; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D008297:Male; D008800:Mexico; D012189:Retrospective Studies; D014504:Urban Health