title: Survival of renal transplant patients: data from a tertiary care center in Turkey.
abstract: OBJECTIVE
  Data on transplantation survival is widely available for developed countries where cadaveric transplantation is the dominant transplantation type. We aimed to assess patient and graft survival and to determine the possible factors affecting graft survival in a developing country where kidney transplantations were mainly performed from living donors.
  
  
  METHODS
  We retrospectively analyzed data from 427 adult kidney transplantations performed at our center from January 1990 to November 2010. We collected data from patient files, including characteristics of the recipients and donors, transplantation-related factors, post-transplantation features, causes of graft loss, and patient death. The Kaplan-Meier method was used to analyze survival, and Cox regression analysis was used to evaluate the effects of multiple factors on graft survival.
  
  
  RESULTS
  Most of the recipients (82.6%) received their organs from living donors. One-year and 5-year graft survival rates were 87.5% and 78.3%, respectively, where the 5-year graft survival rates were 87.1% for living donors and 74.8% for cadaveric donors. The 1-year and 5-year patient survival rates were 90.9% and 88.9%, respectively. Univariate analysis showed that predictors for better graft survival were serum creatinine levels <1.5 mg/dL at 1 month after transplantation, proteinuria <500 mg/d at 1 year after transplantation, use of tacrolimus and mycophenolic acid derivative-based immunosuppression at baseline, living-donor transplantation, and transplantations performed in the years 2000-2010.
  
  
  CONCLUSIONS
  We report data on kidney transplantation in an emerging country where living-donor transplantation constitutes a large proportion of kidney transplant activities. Modern immunosuppressive medications help to achieve a better survival. Our 5-year results are similar to those of developed countries.
authors.affiliation: Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: H
authors.initials: H
authors.lastname: Soylu
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Oruc
authors.affiliation: Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: O K
authors.initials: OK
authors.lastname: Demirkol
authors.affiliation: Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: E S
authors.initials: ES
authors.lastname: Saygili
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: R
authors.initials: R
authors.lastname: Ataman
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: M R
authors.initials: MR
authors.lastname: Altiparmak
authors.affiliation: Department of General Surgery, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Pekmezci
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey. Electronic address: nseyahi@yahoo.com.
authors.forename: N
authors.initials: N
authors.lastname: Seyahi
mesh_terms: D000328:Adult; D000368:Aged; D003404:Creatinine / Q000097:blood; D003906:Developing Countries; D005260:Female; D006085:Graft Survival; D006801:Humans; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000401:mortality* / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects / Q000401:mortality*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000627:therapeutic use; D012189:Retrospective Studies; D016019:Survival Analysis; D015996:Survival Rate; D016559:Tacrolimus / Q000627:therapeutic use; D062606:Tertiary Care Centers; D014421:Turkey
chemical_list: D007166:Immunosuppressive Agents; D003404:Creatinine; D009173:Mycophenolic Acid; D016559:Tacrolimus