title: Patient and graft outcome in current era of immunosuppression: a single centre pilot study.
abstract: OBJECTIVE
  The present single centre study aims at analyzing the impact on renal allograft outcome of the important changes which occurred in the transplant population and immunosuppressive therapy during the last two decades.
  
  
  METHODS
  From 2000 to 2013, 779 single kidney transplantations were performed on 635 patients who all received on an intent-to-treat basis steroids, a calcineurin inhibitor, mycophenolate mofetil and an induction therapy with either antithymocyte globulin or an antagonist directed to the interleukin (IL)-2 receptor. Uni- and multivariate analyses of patient and immunologic graft survival were conducted.
  
  
  RESULTS
  The sole factor predicting patient survival is recipient's age: 10-year survival rates are 94·7, 81·6 and 57·9% for the <45, 45-60 and >60 years age groups, respectively (P<0·001). Peak (>50% panel reactive antibodies) anti-human leucocyte antigens (HLA) sensitization, cold ischaemia time and HLA-B and -DR mismatches (MM) influence graft outcome: at 10 years, the difference in 10-year survival rates is 5·9% between grafts from sensitized and not sensitized patients (90·9 vs 96·8%, P = 0·002), 3·8% between grafts with <18 and ≧18 hours cold ischaemia (96·6 vs 92·8%, P = 0·003), 7·3% between grafts with no MM and either B or DR MM versus those with B and DR MM (96·8 vs 89·5%, P = 0·002).
  
  
  CONCLUSIONS
  In our single centre experience, graft survival was most strongly determined by HLA matching, offering excellent long term graft outcome to most patients.
authors.forename: A
authors.initials: A
authors.lastname: Goubella
authors.forename: N
authors.initials: N
authors.lastname: Broeders
authors.forename: J
authors.initials: J
authors.lastname: Racapé
authors.forename: A
authors.initials: A
authors.lastname: Hamade
authors.forename: A
authors.initials: A
authors.lastname: Massart
authors.forename: J-M
authors.initials: JM
authors.lastname: Hougardy
authors.forename: A D
authors.initials: AD
authors.lastname: Hoang
authors.forename: D
authors.initials: D
authors.lastname: Mikhalski
authors.forename: T
authors.initials: T
authors.lastname: Baudoux
authors.forename: F
authors.initials: F
authors.lastname: Gankam
authors.forename: P
authors.initials: P
authors.lastname: Madhoun
authors.forename: F
authors.initials: F
authors.lastname: Janssen
authors.forename: A
authors.initials: A
authors.lastname: Le Moine
authors.forename: J
authors.initials: J
authors.lastname: Nortier
authors.forename: P
authors.initials: P
authors.lastname: Vereerstraeten
mesh_terms: D000328:Adult; D005260:Female; D006085:Graft Survival; D006801:Humans; D007165:Immunosuppression Therapy / Q000639:trends*; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects
keywords: HLA matching; Kidney transplantation,; Patient and graft survival,