title: Long-term allograft survival after kidney transplantation.
abstract: BACKGROUND
  Technical and medical advances over the past few years have produced an important increase in the functionality of renal allografts. The aim of this study was to identify the factors associated with allograft survival 15 years after transplantation in our series.
  
  
  METHODS
  A retrospective study of kidney transplantations was carried out at Reina Sofia Hospital in Cordoba from February 1979 to December 1997, with follow-up through June 2012. A subanalysis of the series was undertaken, and Kaplan-Meier analysis and Cox proportional hazards model regression used to achieve the main objective of the study.
  
  
  RESULTS
  A total of 487 renal allografts with a mean follow-up of 114 months were studied, of which 37% (n = 180) survived for >15 years. Of the 180 patients, the main causes of graft failure were chronic allograft nephropathy in 29 (66%) and patient death in 13 (29.5%). Multivariate analysis identified the number of HLA mismatches (hazard ratio [HR] 1.25, 95% CI 1.01-1.56), panel reactive antibodies (HR 2.61, 95% CI 1.28-5.26), and delayed graft function (HR 11.25, 95% CI 1.33-95.28) as being significantly associated with graft loss after 15 years.
  
  
  CONCLUSIONS
  The high immunologic risk of the patients was independently associated with graft loss. Delayed graft function was the most important factor in the speed of graft failure beyond 15 years.
authors: Urology Units, Reina Sofía University Hospital, Córdoba, Spain. Electronic address: enriquegomezgomez@yahoo.es.
authors: E Gómez
authors: EG
authors: Gómez
authors: J P Campos
authors: JP
authors: Hernández
authors: F J Márquez
authors: FJ
authors: López
authors: J Ruiz
authors: JR
authors: Garcia
authors: V Garcia
authors: VG
authors: Montemayor
authors: F Anglada
authors: FA
authors: Curado
authors: M Leva
authors: ML
authors: Vallejo
authors: J C Regueiro
authors: JC
authors: López
authors: M D Navarro
authors: MD
authors: Cabello
authors: P
authors: P
authors: Aljama
authors: M J Requena
authors: MJ
authors: Tapia
mesh_terms: D000328:Adult; D064591:Allografts; D000906:Antibodies / Q000097:blood; D016009:Chi-Square Distribution; D051799:Delayed Graft Function / Q000276:immunology / Q000401:mortality; D005260:Female; D006084:Graft Rejection / Q000276:immunology / Q000401:mortality; D006085:Graft Survival; D006680:HLA Antigens / Q000276:immunology; D006648:Histocompatibility; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects / Q000401:mortality; D008297:Male; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000906:Antibodies; D006680:HLA Antigens